Jason Fodeman

2011 has commenced and even though New Year’s cards may still remain prominently displayed on the kitchen table, a newly implemented provision of the health care overhaul law likely has some physicians and patients across the country yearning for the good old days of 2010. As of January 1, 2011, the Patient Protection and Affordable Care Act (PPACA) states patients with flexible savings accounts (FSAs) and health savings accounts (HSAs) can no longer use these tax-sheltered vehicles to purchase over-the-counter (OTC) medicines without a doctor’s prescription. This legislation will adversely impact physicians, patients, health care costs, and flies in the face of the enabling law that established these programs.

Previously, patients with these patient-directed plans could go to the local CVS or Walgreens and use their account to purchase an OTC medicine. Now patients need a prescription. This applies to a multitude of commonly-used medicines such as Zyrtec, Claritin, Benadryl, Prilosec, Zantac, and many, many others.

Ultimately, this eviscerates the usefulness of these programs and will lead to extra, unnecessary work during physician-patient encounters. Doctors will now have to waste time writing OTC prescriptions for those who want to utilize their accounts. These are precious minutes that physicians could better spend performing other vital tasks such as making sure a patient understands a treatment course or warning signs to look out for. Additionally, this could lead to superfluous office visits by likely forcing some patients to make extra appointments just so they can get OTC prescriptions. This inundation will likely impact primary care physicians the most.

Let us not forget a severe physician shortage exists in this country. As millions of newly insured people formally enter the health care system, that shortage is only going to get worse. Health care providers need policy makers to foster efficiency and help them to maximize scarce resources. This law does the opposite. It makes the efficient inefficient and lacks any positive rationale for its existence.

For patients, the statute will be equally annoying. It will compel those privy of the intricacies of PPACA to waste time tracking down their physicians to acquire these now necessary prescriptions. This will mean more phone calls, more letters, and more time waiting in a physician’s office. Not exactly what the doctor ordered!

Of course, it’s safe to assume that some people between working and raising a family may have missed the memo about these new restrictions and will continue with business as usual. Down-the-line these patients could face penalties and problems with the IRS for using these special accounts contrary to the mandates.

Extra medical visits will culminate in additional health care costs. This law could also push some doctors to order more expensive trade-name drugs, which would exacerbate the impact on health care costs.

In fact the provision undercuts the very purpose of these consumer-driven plans. Their goal is to empower patients to shop around and become smarter health care consumers. Data shows they do in fact work. Yet, this legislation throws a monkey wrench in their success. It makes them more cumbersome and less attractive to patients. Unfortunately, more restrictions with these popular accounts are in the works. The new law puts them on a trajectory to oblivion, which is consistent with the administration’s vision of a one-size fits-all medical system regulated by bureaucrats.

In outlining a new regulatory review, President Obama recently wrote “we are also making it our mission to root out regulations that conflict, that are not worth the cost, or that are just plain dumb.” If the President is truly serious about this objective, perhaps the 1,000’s of pages of regulations emanating from ObamaCare would be a good place to start.


Jason Fodeman

Jason D. Fodeman, M.D. is an Internal Medicine Resident at UCONN and a former health policy fellow at the Heritage Foundation.