Health Care Spending Accounts – No More Claritin or Tums

23 Mar

Note: This is a guest entry written by Dr. Z., a practicing physician, medical educator, and curmudgeon.

Via John Lott’s site, I see other people noticing a problem with health care spending accounts (HCSAs).  Lott links to this Wall Street Journal article regarding the problems people have with HCSAs.

I have a health care spending account. I love it. Every year, in November, I sit down and figure out how much money I will need to pay for prescriptions, co-pays, eyeglasses, and the like. I then put that amount of money into my health care spending account, and in return I get a nifty little debit card that I use to pay for the covered items. Stuff goes into the HCSA before taxes, so I get forced savings and a little tax break.

For some reason, people don’t like health care spending accounts. Mainly, I believe, because it saves the average person some money, and keeps money out of the hands of the government. One of the provisions in the health care bill is HCSA money can only be used for prescription items. Over-the-counter stuff, which used to be covered, is not.

So, people are going to the doctor to get prescriptions to use their health care spending account money. Of course, this leads to expenses with the pharmacies, and the extra paperwork. It leads to extra co-pays. Some doctors are worried about being sued for prescribing OTC meds, if something goes wrong. Personally, I think I should start a service where I write scripts for all these OTC things. I’d be happy to, it could be a real moneymaker–even at $10.00/script. The documentation would be a killer, though. That’s where all the money would go, into keeping the charts. You can’t just write a prescription, you have to write scripts only on people on whom you keep medical records. I need to think about it.


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