Wednesday, January 26, 2011

Why Spend Your Own Money When Somebody Else Will Pay?

A hospital employee approached me the other day and asked politely if I would sign a prescription for him. I've worked with him for years and know him to be a decent honest guy who wouldn't abuse this courtesy. I looked at the prescription form that he had already filled out which only required my signature and medical license number on the bottom to complete. When I looked at the medication he had written, I was surprised. It was for a very common over the counter pain medicine. It wasn't the usual antibiotics or prescription strength pain meds or muscle relaxants that most people ask for.

I looked at him and asked, "Why do you need a prescription for this? Can't you just buy this at the pharmacy or supermarket? It shouldn't cost much more than $5." His reply says a lot about the state of the health insurance industry in America today. He said he needed a documented prescription filled out by a doctor so that his health insurance policy will pay for it. Otherwise he will have to pay out of pocket for the medication.

Now I can't really blame the guy for working the system. Isn't that what all smart consumers are supposed to do, milk the process for every last penny? If his insurance policy will pay for his drugs, even generic OTC meds, why should he pay for it himself? Does it matter that such behavior eventually drives up the cost of health insurance premiums for everybody? If Joe next door is doing it, why should Bob have to pay higher premiums without getting his fair share? Though it makes as little sense as your auto insurance policy paying for your gas, patients in America will be damned if they have to pay out of pocket one single cent more than necessary for their healthcare. If the government is demanding that insurance companies cover mental health services, obstetric services, physical therapy and chiropractic services, and every other global desire that few will actually use, further driving up insurance costs, why shouldn't I take advantage of it to the fullest extent possible?

Yeah I signed his prescription. Though I shook my head at the absurdity of these arcane rules set up by the insurance companies, who am I to deny my friend his right to his cut of our country's $2.5 TRILLION health care industry?


  1. It's entirely possible that this employee's insurance policy was set up to do the right thing before Obamacare screwed him and other beneficiaries.

    The idea behind Flexible Spending Accounts is that you set aside your own money to pay for things like OTC and prescription drugs, thus giving you the incentive to shop around and pay attention to price.

    The PPACA included provisions that require FSA-holders to get prescriptions for OTC medications if they want to be able to use FSA money for them. Why? By making FSAs less useful and attractive, fewer people would get a tax advantage for using them, thereby "saving money."

  2. When I was in general practice, OTC drugs were often not covered under prescription drug plans which made you very unpopular when you felt the most appropriate medication was the OTC one.