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  1. #1 In Health Law, Rx for Trouble 
    In Health Law, Rx for Trouble

    By JANET ADAMY

    Dr. Sandy Chung, a Virginia pediatrician, says she is inundated with requests to prescribe nonprescription drugs because of the new health law.

    Patients are demanding doctors' orders for over-the-counter products because of a provision in the health-care overhaul that slipped past nearly everyone's radar. It says people who want a tax break to buy such items with what's known as flexible-spending accounts need to get a prescription first.

    The result is that Americans are visiting their doctors before making a trip to the drugstore, hoping their physician will help them out by writing the prescription. The new requirements create not only an added burden for doctors, but also new complications for retailers and pharmacies.

    "It drives up the cost of health care as opposed to reducing it," says Dr. Chung, who rejected much of a 10-item request from a mother of four that included pain relievers and children's cold medicine.

    Though the new rules on over-the-counter drugs amount to a small part of the massive overhaul of the health-care system, the unintended side effects show how difficult it can be to predict how such game-changing legislation will play out in the real world.

    Some doctors, irked by the paperwork and worried about lawsuits, are balking at writing the new prescriptions. Pharmacists and retailers say the changes mean they have to apply a personalized label on some 15,000 different everyday products for customers paying with certain debit cards.
    [OTC_p1]

    The over-the-counter provision isn't the only part of the health-care law that has defied expectations.

    Health-policy experts predicted that new insurance pools for high-risk patients would attract so many expensive enrollees that funding would be quickly exhausted. In fact, enrollment is running at just 6% of expectations, partly because of high premiums.

    A provision preventing insurers from denying coverage to children with pre-existing health conditions prompted insurers in dozens of states to stop selling child-only policies altogether.

    And a piece of the law designed to centralize patient care by encouraging health-care providers to collaborate is running into antitrust concerns from regulators.
    WSJ
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  2. #2  
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    The more that comes to light about this health care abomination, the more there is to not like. Over 1000 companies and unions have been exempted. Sect Sebelius, of Health & Human Resources, testified that the 500 billion of savings from reducing Medicare costs was transferred to Medicaid. In other words, this administration double counted half a trillion dollars of saving by accounting trickery methods that would make the books at Enron look legal.

    I think people going to the doctor to obtain pain and cough meds are just trying to scam the system. This is bullshit. Doctors should not only refuse but should not allow the patient to use their insurance thus causing them to pay the entire doctor bill.
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    Quote Originally Posted by lacarnut View Post
    I think people going to the doctor to obtain pain and cough meds are just trying to scam the system. This is bullshit. Doctors should not only refuse but should not allow the patient to use their insurance thus causing them to pay the entire doctor bill.
    The way I'm reading this, these people are not trying to scam the system. Normally, you can use medical spending account money for these items, but apparently this law is trying to stop some kind of abuse of medical spending accounts and in the process has complicated and screwed up the system.

    I think the 1099 situation was similar. I think they 1099 was supposed to make it harder to work off the books, but what the change in the law did was make it exceptionally hard for businesses to comply.

    The bottom line is that we need to go to a Single Payer system, but for that to work we have to get the illegal aliens out of the country, secure the border, and make it so that everyone is paying into the system including those being paid under the table.
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    Quote Originally Posted by Novaheart View Post
    The way I'm reading this, these people are not trying to scam the system. Normally, you can use medical spending account money for these items, but apparently this law is trying to stop some kind of abuse of medical spending accounts and in the process has complicated and screwed up the system.
    You are correct. FSA accounts are use-it-or-lose-it and near the end of the year, buying over the counter drugs was a way to use-it for me. Also, people get accustomed to a benefit and it is difficult to take it away.

    For my part, I just pay for my Tylenol. It's not that big of a deal.
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    Quote Originally Posted by Gingersnap View Post
    [ Health-policy experts predicted that new insurance pools for high-risk patients would attract so many expensive enrollees that funding would be quickly exhausted. In fact, enrollment is running at just 6% of expectations, partly because of high premiums.

    A provision preventing insurers from denying coverage to children with pre-existing health conditions prompted insurers in dozens of states to stop selling child-only policies altogether.
    So what are these people supposed to do?

    Here's a vicious circle for you:

    Big cities have lots of people who have no health insurance. Those people go to the hospital for routine health care because the ER has to take them. These people have long ago given up on the idea of good credit, so hospital bill collectors don't bother them. The city foots the bill for this most expensive form of health care, and so the city has to raise taxes to keep the public hospitals open in addition to regular city services. The high taxes discourage most middle class people from living in the city, so you have a city that is 80% poor and 20% rich. Because so much of the city is in the dumper, you have to raise taxes even more, which discourages people from buying houses in the city.
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    Taking Novaheart seriously, what are we to do? His figures may not be scientific, but they are roughly correct, I think.

    We are generating a class of dependent people who have become experts at gaming the system. And at the same time we are generating a class of hapless victims. It is a very dangerous path, and one that will not end well. There have always been people in those categories, but the number is becoming too large.

    And we are generating a class of terrified physicians, too. This morning I heard a physician comment that he was afraid to prescribe many over the counter, common medications because it then puts the liability on him! You know..."The doctor told me to take it and my stomach blew up" kind of thing.
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    Quote Originally Posted by TruckerMe View Post
    Taking Novaheart seriously, what are we to do? His figures may not be scientific, but they are roughly correct, I think.

    We are generating a class of dependent people who have become experts at gaming the system. And at the same time we are generating a class of hapless victims. It is a very dangerous path, and one that will not end well. There have always been people in those categories, but the number is becoming too large.

    And we are generating a class of terrified physicians, too. This morning I heard a physician comment that he was afraid to prescribe many over the counter, common medications because it then puts the liability on him! You know..."The doctor told me to take it and my stomach blew up" kind of thing.
    I took Novaheart's story as an indication of how urban areas are used for commerce and economic benefit while the people who do so live outside its juristiction and therefore the obligations faced by urban populations.
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    FSAs are accounts funded by your own money. Why not let people spend it on over the counter drugs? Perhaps this is a way to make the program less popular and appealing.
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    Quote Originally Posted by Lager View Post
    FSAs are accounts funded by your own money. Why not let people spend it on over the counter drugs? Perhaps this is a way to make the program less popular and appealing.
    In Singapore, everybody has HSAs and everybody pays into a tax for catastrophic care. You can spend your HSA money on Western medicine or Eastern medicine or on over-the-counter stuff. It's up to you. You decide what hospital, clinic, or doctors you want to deal with.

    If you get in a situation that uses up all of your HSA money, you get government care. It's something people try desperately to avoid but it is available.
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    Quote Originally Posted by Gingersnap View Post
    In Singapore, everybody has HSAs and everybody pays into a tax for catastrophic care. You can spend your HSA money on Western medicine or Eastern medicine or on over-the-counter stuff. It's up to you. You decide what hospital, clinic, or doctors you want to deal with.

    If you get in a situation that uses up all of your HSA money, you get government care. It's something people try desperately to avoid but it is available.
    Years ago, John Stossel was praising Hong Kong's system. It's a 15% flat tax , can't recall if it's an income or sales tax, and everyone has health care, though I can't recall if it's NHS or Single Payer.
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