Since the late 1980s, Clark has thought it's crazy that medications can only be dispensed when a doctor writes a prescription. Many other countries have their pharmacists write scripts and dispense the medication. The FDA is now considering adopting a similar policy. We're not talking highly addictive things like Vicodin or Oxycontin here; we're talking about two-week cycles of antibiotics and other relatively benign medications. Clark loves this idea. Doctors are already overworked and in short supply. Because pharmacists are very well-trained and knowledgeable about medications, it's almost a no-brainer to allow them to pick up some of the slack. The Los Angeles Times reports that Kaiser Permanente pharmacists already have the authority to write and fill their own scripts.

Pharmacists are a vastly underutilized resource. To treat them like clericals who just fill prescriptions isn't Clark Smart. The numbers of primary care doctors are down 50 percent, so empowering pharmacists to write prescriptions is one possible solution to the shortage. Clark knows doctors will be up in arms about his feelings on this issue, so he's ready for the fallout on the Clark Stinks forum! On a related noted, Minnesota has banned pharmaceutical sales reps from giving free gifts and meals to doctors. These kinds of sales practices subtly influence the brand choices doctors make when they write prescriptions. Now The New York Times reports that the pharmaceutical companies have come up with yet another tactic to influence the selection of scripts; they're wooing nurses and office managers since they can't get to the doctors anymore!

Navigating the healthcare maze can be an exhausting process if you or your family members are sick. Employers are starting to understand this and make healthcare advocates available to their employees as a free benefit. Healthcare advocates are usually former medical professionals who help people get what they need from the medical system. Right now about 3,000 employers offer healthcare advocate access. But very few workers even know they're entitled to such a benefit. Clark thinks of the healthcare advocacy phenomenon like he does expeditors. When you live in a city, sometimes you can hire an expeditor who knows the right people to contact to expedite any request. In the same way, healthcare advocates can assist you in getting to doctors and certain facilities that you might not be able to get into on your own. Of course, it goes without saying that healthcare should not be this difficult. Yet that's the reality. Healthcare spending accounts for 1 in every 6 dollars in our economy and it's not slowing down anytime soon.

Health benefits are becoming more and more expensive for employers to provide. The Dallas Morning News estimates that the average employee will cost their company $9,312 next year. In classic cost-shifting mode, your share is going to steadily rise too. Employer costs are up about 50 percent over the last five years, but employee portions are up around 60 percent! Healthcare accounts for 1 in every 6 dollars spent in our country. So this hot potato issue is only going to keep getting hotter. Clark advises people to pay close attention during open enrollment periods. You need to make the smartest choice you can. If you choose unwisely, you may have limited and expensive access to certain services should you become ill. The latest stats show that the average employee will pay $165 out-of-pocket every month in 2008. But Joel -- one of Clark's producers -- is 23 and can buy an individual policy for about $65 per month because of his young age. That's without any employer subsidy. Meanwhile, Clark at 52 years of age would be charged big bucks for the same policy. The cost rises as you get older. Yet older workers rarely call out sick unless they're truly ill -- unlike younger folks who take mental health days. But it all balances out because older workers tend to be out for longer when they actually do get sick.

This time of year, people choose whether to contribute to their 401k plans and pick what kind of health plan in which to enroll. With all those choices, how do you know which plan to pick? One annual report known as The Health Competence Survey found that more than half of people are in shell shock over the cost of coverage next year. People are seeing such large increases in health care costs that they are going to reduce the amount they contribute to their 401k plans. That is unfortunate, but it’s a sign of the times. So, when looking at jobs these days, consider health care, bonuses and other benefits. Typically, an employee only thinks of salary. But health care is huge these days. One alternative is a high-deductible health plans. Clark thinks these are great for people who own their own businesses and for contract workers. HSA plans are another option that Clark supports. Many people don’t have money saved, so paying the big out of pocket costs is not realistic. But for others it could be a great idea. For more on HSAs, click here.

We spend $1 out of every $6 on health care in the United States. That’s much higher than any other wealthy country in the world. Yet, we have lower life expectancies than dozens of countries out there. Where does the problem lie? A professor at MIT looked into the subject and found that most of the money was going to hospitals, doctors and pharmaceutical companies. It happens because we don’t act like consumers when it comes to our health care. Instead of asking what something costs, we just care about what the co-payment is. HSAs will help curb this way of thinking, in Clark’s opinion. Health savings accounts require that we monitor what we spend because of the way they are structured. We don’t know if these will have an affect, but Clark sure hopes so. We must change how each of us views our responsibility if we want the health care system to improve.

Clark is a big advocate of Health Savings Accounts or HSAs, a new form of health coverage for which more than one million people have signed up. The most interested are the self employed and small business owners, but more corporations are starting to offer HSAs to employees, as well. Basically, members pay a $1,000 deductible up front and, in return, their premiums go down over time. At the same time, members can put money into a tax- free HSA, which earns interest and can be used down the road to pay for healthcare. It changes things because the member becomes the customer, not the company supplying the insurance. The problem is that some companies charge a significant amount to open an account. The Web site hsafinder.com lists the 10 worst companies out there today, and the worst one charges a $235 fee annual fee. So, if you open an account with $1,000, you immediately have only $765. Other companies charge no fee at all and those are the companies you want to join. When setting up your HSA, be aware of what charges are involved. There shouldn’t be any!

Health care in the United States is outrageously expensive, as you well know. Problems started in the '60s when companies offered to provide health coverage in lieu of pay raises and other benefits. The problem was people began not caring how much it cost because they weren’t paying. The whole thing has been upside down and backwards ever since. Well, fast forward to today when there is help on the way. Health Savings Accounts (HSAs) will provide us with that alternative. These are tax-advantaged accounts that allow individuals to shop around and keep track of how much health care costs them. You can end up with a big pile of cash if you remain fairly healthy. Information is slowly trickling out about these accounts and now there is a site that lists opportunities by state. It is hsadecisions.org.

You may have heard of Health Savings Accounts or HSAs but you’re not really sure what they are. It’s the Bush administration’s main initiative in the health care area and Clark really likes the idea. Right now, the health insurer and your employer are the customer, and you’re in third position. No one cares about you and you have no say in what you pay. But with an HSA, you get a trade-off. You get much lower premiums for health coverage, but you have to pay the first minimum $1,000 for coverage. The money you don’t spend, goes into a tax-free savings account known as an HAS. It earns money tax-free and is used tax free to pay for medical expenses. Now, if you see the doctor frequently, an HSA is not a good idea. But for many, it’s a huge improvement because you will be more conscious about how much you’re spending. Kaiser Permanente, one of the largest health care companies, is getting in on the HSA game early. The company is concerned about losing customers to individual HSA plans. So, as an experiment, the company is going to allow customers to buy an HSA plan through Kaiser. About one in four Kaiser members will be eligible. The premiums will be much lower, but the doctor visits will cost much more. It won’t be the typical $10 or $15 co-payment. It’s not the traditional Kaiser business model, but Clark congratulates them for trying something new. The market place will decide if it’s a good idea or not and we’ll keep you posted.

Clark has been getting a lot of calls from listeners about Health Savings Accounts or HSAs since Congress passed the law recently. These accounts are going to become a household name in the next few years, but right now they are very confusing. HSAs look at health care very differently. The idea is to make health care more of a patient-oriented system. Right now, you fill out medical forms and you might pay a co-payment or a percentage of the bill. And you have to check if your doctor or specialist is in your “network.” With HSAs, people are now “customers.” The first certain number of dollars come out of your pocket. After that, all the bills are paid by your health care plan. The idea is that you’ll try to think of a less expensive way to get care if you’re paying for it. If we’re spending someone else’s money, we don’t really care about it. With HSAs, your deductible could be as high as $2,600 or as low as $1,000. But the great thing is it’s up to you, and it’s tax free. And if you buy a policy that has a $1,500 deductible, you’re free to put $1,500 into it and it’s never taxed. HSAs will be available from large employers, small employers and the self-employed. It’s still very early in the HSA game, but we’ll keep you posted. There are some people who don’t like HSAs, of course. They think all of the money is being funneled to the rich. But, it’s better than our current system. Of all the economic output in the United States, 15 cents on every dollar goes to health care. That’s about 50 percent higher than any developed country. So, we are basically sapping our nation’s economic growth with the enormous amount of money going to health care.