Monday, October 12, 2015

Issue 697 HSA: Government Improvements October 12, 2015

Continuing from last week's issue on health savings accounts (HSA's), there are methods to speed up their adoption and make them more useful.  Of course as always it is up to the government to do it because they, as usual, are in the way.

What Government can do:  While HSA's will gradually take over as the primary payer for health coverage over time (my prediction), government can aid in speeding things up via a few methods.

Method 1) let generic drugs stay on the market longer:  By letting these drugs stay on the market longer, and potentially allowing more manufacturers to produce their own versions of these generics, it will flood the market with cheaper drugs.  As such, copays become cheaper, and out of pocket costs become cheaper thanks to greater supply of the drugs and choice of which manufacturer to buy it from.

Method 2) Auto-substitution:  In some States in the United States, pharmacists can substitute one drug with another on their own if the medication is of equivalent therapy.  As such, they can change one heart medication to another if the patient requests it without necessarily consulting the doctor.  This means that drugs that are not covered can be automatically switched out for those that are or are cheaper with respect to a needed therapy for the patient.  To gain this advantage in cost and time savings this ability of pharmacists can be made universal.

Method 3) Mass produce drugs:  Drug companies have to tell the FDA how much they will produce of a drug each year and if they wish to produce more or less of that drug, must get their approval.  This was primarily done to resist greedy drug companies causing price spikes by reducing the amount of drugs they produce to increase the price due to supply or undercut competition via price by producing more.  I could care less if they undercut competition as the patient's benefit, and thus eliminate the need to get FDA approval to produce more of the drugs which makes them cheaper.

Method 4) Sponsor more alternatives:  With respect to alternatives, this means the usage of doctors.  Midwives can replace doctors in delivery rooms, and nurse practitioners can replace doctors in clinics.  Sponsoring more people to be in these alternate professions that do the same job as a doctor makes health care cheaper.  We are not limited to just existing alternatives either.  Other more specialized or generalized positions in health care can be created to suit needs of the current health care system while working with colleges and hospitals to find out the health care systems overall needs.

Method 5) Unlock limits: The Congress makes the rules on HSA's and what they are allowed to cover (as far as my understanding goes).  As such, free up HSA's to have larger yearly limits, have that money roll over to aid in saving for future healthcare issues, and expand what they can purchase to certain over the counter items relating to healthcare like band aids, stomach acid medication and similar.

Method 6) More OTC drugs: There are a number of drugs that are prescription only that can potentially become over the counter items or even become an in-between like Sudafed products like Alive-D, Advil cold and Sinus and Zyrtec-D.  This makes even more drugs readily available to be purchased and thus cheaper to buy.


Conclusion:  As you can see, almost all of these methods revolve around making health care cheaper and thus more affordable.  By doing that, insurances can potentially lower premiums, or cover certain drugs less and use the HSA to do the grunt work with respect to coverage.  With an HSA's flexibility, cheaper drugs and doctor equivalents means more affordable health care

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