My wife and I enjoy our Flex Spending Account. We put in enough money each year to cover the various drugs we’ll need to buy (both prescription and non-prescription), a new pair of glasses, and money to cover any other medical expenses we anticipate. Next year, I’m planning on putting in an extra $4000 for corrective laser eye surgery, so that I can finally stop wearing glasses. We like the plan we have.

Well, under the Senate healthcare bill, we’ll no longer have that plan.

Both the House and Senate bills include a change in the definition of a “qualified medical expense” that impacts reimbursements and withdrawals under all types of health care accounts (i.e., FSAs, HRAs, HSAs, and Archer MSAs). As of 2011, expenses incurred for over-the-counter (OTC) medications and products will no longer be eligible for payment or reimbursement from any of the health care accounts. The House bill definition appears to apply to all OTC medications. However, the Senate bill would still allow OTC medicines obtained with a prescription and insulin to be reimbursed or paid tax-free from the health care accounts.

The most significant change likely to be enacted is an annual limit on contributions made by employees to flexible spending arrangements (FSAs) for health care. Both the House and Senate versions of health reform legislation would limit contributions to no more than $2,500 annually. The limit would be indexed to inflation for future years. Under the House bill, these changes would not take effect until 2013. In the Senate bill, these changes would take effect in 2011.

If the current “reform” bills, I wouldn’t be able to buy OTC drugs — Sudafed, Mucinex, ibuprofen, Tylenol — tax free. If the “reform” bills pass, I wouldn’t be able to save tax free for corrective eye surgery. I would no longer have the plan I like.

It’s just one more broken promise from a president that’s building quite a pile of them. Apparently, “yes we can” act just like any other politician.

But talk to a retail pharmacist about her job sometime. Listen closely to what she does most often. You’ll find that she’s basically a human vending machine. When she’s not grabbing drugs off of a shelf and putting them in a bag for patients, she’s probably swiping an insurance card and figuring out how much they owe. Occasionally, she’ll get to answer questions about how the drug works and how it interactions with other medicines, but that’s comparatively rare.

Enter the pharmacy vending machine.

Integrity Urgent Care, 4323 Integrity Center Point, in northeast Colorado Springs, recently installed a machine stocked with dozens of common prescriptions — antibiotics, painkillers, asthma inhalers and oral steroids. It dispenses patients’ medications like a bag of potato chips or package of Skittles, and it is the first such machine in Colorado, according to the Minneapolis-based manufacturer, InstyMeds.

The process works like this: The doctor or physician’s assistant submits the prescription electronically to the machine and gives the patient a code. The patient types in the code and a birthdate and receives the medicine after the bar code is triple checked.

A phone on the machine connects the user directly to a pharmacist 24/7 if the customer has questions or concerns.

If you’re job is to perform the function of a vending machine, you probably won’t be too happy that an actual vending machine is being used. Enter, the APhA spokesperson:

Kristen Binaso, a New Jersey pharmacist and spokesperson for the American Pharmacists Association, said people need quick access to their medications, but she said people should understand that a drug is not a package of Ritz crackers. Even certain common drugs can increase sensitivity to the sun, react negatively to alcohol, cause diarrhea, or interact with vitamins, herbs and over-the-counter drugs.

Her statement ignores something: the FDA mandates that all drugs come extensively labeled with warnings about every possible danger or complication. So, it sounds like a vending machine can replace much of what a retail pharmacist does on a regular basis.

And, this is a good thing. I wish that more pharmacists would recognize this. There is a very limited future in taking an average prescription, putting the pills in a bottle in a bag, reading the list of drug warnings, and taking payment.

The future of pharmacy is in the work that machines can’t (yet) do: helping a patient recognize what the “blue pill”, “red pill”, “square yellow pill”, and “round yellow pill” actually are. Helping that patient understand what each drug is supposed to, how it should make them feel better, what to be aware of when it it’s not working, knowing which side effect goes with which drug(s), etc. Pharmacists have a great future in helping patients know whether their particular cocktail is safe or whether there’s a potentially deadly interaction between multiple drugs.

But all of that counseling work can’t be done well in today’s retail setting. Today’s retail setting is focused around volume, not around thorough counseling sessions. And that’s not going to change until retail pharmacists are willing to allow vending machines to take over the tedious, rote work of actually dispensing pills.

On a closing note: what does it mean when people talk about a shortage of pharmacists? Are they referring to a shortage of dispensers? Well, technology can help with that? Or are they referring to a shortage of counselors? Technology can help with that too. By freeing pharmacists from the drudgery of being a vending machine, technology will create more pharmacist hours to be used for counseling. It will be as though thousands more pharmacy graduates entered the market, ready to help.

Thank you InstyMeds. You’re helping to take us forward to the future.

What caused this remarkably slow growth? Maybe it’s because 25 cents out of every dollar spent on prescription drugs comes straight out of consumers’ pockets. Maybe consumers really are more frugal when they’re spending their own money.

It seems more than a little overkill to ban an entire class of medicines just because a few doctors start jumping up and down and yelling “There’s no proof that it works! No proof!”

And look at the number of children supposedly killed by these medicines in a 37 year period: 123. That’s about 3.3 children per year. Far, far more than that are killed via accidents every year (such as parents backing over kiddies with the SUV) than by baby dimetap. Some perspective might be in order here.