I Think Our Way Over Regulated Drug Prescription Policy is Ridiculous!

Great Debates
21

wevets wrote:

Again, with the drugs that can breed resistant strains of bacteria if not used properly, these do directly threaten the health and safety of others, and so they should be regulated.

But with the notion that somebody misusing otherwise-prescription drugs “damages” the health care system by “diverting” its resources, I have to take exception.

The only reason this is the case is because we’ve decided, somewhere along the line, that health care is a “right.” That if a person can’t afford treatment, the government should step in and cover that person’s health care costs with tax money. I should remind you that no governmental policy like this existed prior to the 19th century, and as far as I know, governmental health care expenditures prior to the 20th century were still next-to-nothing. Government-supported civilian health care is a recent phenomenon. The obvious solution? Stop spending taxpayer money to treat cases of drug misuse. If a person takes the drugs in a manner specifically denounced by the drugs’ manufacturer, and he gets sick as a result, it should be his own damn problem to pay for any cure for his mistake, and nobody else’s. Sure, this will put a “strain” on the health care industry. At first. But as any first-year economics student will tell you, the increase in demand for health care services will result in an increase in the price of those services – which will encourage more people to enter the health care field and to put research-and-development effort into improving health care technology, both of which will increase the supply of health care services, which will bring the price of health care back down.

Did the sharp increase in demand for microcomputers in the early 1980s “damage” the computer industry? No. It caused it to flourish as never before. And now, a computer that cost $3000 twenty years ago would cost maybe $200 today, tops, while the $3000 computers of today have literally a thousand times the processor speed, RAM, and hard disk space of a $3000 computer in 1981. Would this revolution have happened if not for the increase in demand? NO! And the same revolution will not happen in health care unless we unshackle it from government subsidies and let it fend for itself.

22

I agree with the pro-prescription folks here, mostly. In the area of antibiotics and hard drugs, sure. But there are some not-so-dangerous drugs that could well be handled by the pharmacist using a national database to prevent interaction and abuse, as they already do.
Pharmacists are actually better trained in the relative dangers of drugs than most doctors. A good one will tell you about how to use the drug and caution about the dangers.
One example is a stronger Tylenol (Tylenol 3?) that I once had a prescription for. Pretty good painkiller, and not all that dangerous, if used as the pharmacist instructed me. I’m sure there are more in this catagory.
Peace,
mangeorge

23

How exactly do the consumers “know they need” a particular medication? A wide range of diseases can exhibit the same basic symptomology and require a wide variety of treatments. I’m a case in point. I “knew” a few years ago that I had pneumonia. I’ve had it before and I know the symptoms. Of course I couldn’t get antibiotics OTC so I had to go to the doctor. Turns out my “pneumonia” was an unidentified mass on my lung which required an in-patient hospitalization of a week and steroid treatment for months after. But I “knew” all I needed was antibiotics, right? Unless you’re a doctor, you probably don’t “know” what’s wrong with you and personally I’d rather people have to find out what’s wrong with them before they take medication for it.

That being said:

This may have once been true, but no longer. Persuading doctors to prescribe certain meds repeatedly or exclusively are huge business for the drug companies. They regularly spend tens of thousands of dollars per doctor to ingrain that drug name to as close as a reflex as possible. Sure, they put out pens and pads, but they also sponsor “seminars” on diseases at which their drug is amazingly the cure for the topic disease. They shell out for dinners, drinks, sports and theatre tickets, “honoraria” to other doctors, and on and on. Doctors claim that this has no effect on them, but come on! If you’ve been dunned with the brand name long enough, it’s going to make a difference in what you prescribe. This is why insurance companies have had little choice but to implement “mandatory generic” provisions in recent years, because doctors write for the brand even when the generic is available at a fraction of the cost. Even some doctors are finally starting to speak out against the way drugs are marketed to them (and to the general public on TV and so forth) and some have even gone so far as to adopt policies within their practices or hospitals of accepting invitations or gifts from any drug manufacturer. Sorry, I realize this is a bit of a hijack, but since I field calls pretty much every day from people asking why they have to pay extra to get a brand name drug instead of the generic I get kind of sensitive to comments like the above.

24

Most of my doctors will prescribe a generic if available. Unfortunately, Paxil will not be available as a generic for quite a while. When we were between insurance companies, my doctor was kind enough to give us plenty of free samples-free of charge.

25

tracer

As a future member of the health care community (I am only a health care apprentice right now), I find your talk on the “universal right of health care” fascinating. I don’t want to hijack this thread, so if you want to continue this debate, I would encourage you to start another thread. I would do it, but I unfortunately am working through a crashed hard drive and can only post at very limited times for the next week or so.

The real issue, as it applies here, is that the medical community does not want to have to ration health care based solely on economic considerations. We are commited to providing care to those in need – that this care is not based on monetary concerns is one of the core concepts of medical ethics. Doctors, in general, have long shied away from moves that would move them more on the scale away from “healer” to “honest businessman.” When a patient is rolled into the ER, the main focus is curing them. Turning away a sick patient due to monetary concerns is against the law (EMTALA). A hospital must treat those in critical need, regardless of ability to pay. If we make it impossible for hospitals to recoup losses from treating drug overdoses (the vast majority will go unpaid, most junkies don’t have $10,000 stashed away in a bank account for such an occasion) one of two things will happen : there will be dead junkies in every hospital parking lot across the country, or there will be bankrupt hospitals across the country. I think neither are a tolerable position.

26

Tracer, we obviously have a fundemental disagreement about the goals of the health care system and the duties of a society towards its members which is beyond the scope of this debate about prescription medicine. Perhaps a different thread?

27

Yeah, tracer.
That line of yours goes wat back. I’ve read that Neanderthal took care of their sickoes.
What’s good 'nuff for Oog is good 'nuff for me.
:stuck_out_tongue:
Peace,
mangeorge

28

Though I’m no great frequenter of GD, I happened to be glancing thru the index & had to register my vote, even though I’ve barely glanced at the other responses. Wild Bill, I’m with you 200%. I believe that everyone has a right to self-determination, as long as they sign a waiver of liability, as you say. I wish many more potent painkillers such as codeine and morphine were as readily available OTC as aspirin, and as cheaply.

The medical system is a wolf cloaked in the facade of sheep’s clothing which imposes slavery rather than freedom of choice. Low-income earners have to slave to earn enough money to pay for medical costs.

I’m a fan of the marijuana-as-medicine org. Theirs isn’t the only site which discusses the many abuses perpetrated by the FDA. Many people in pain from conditions such as Crohn’s have been abused by a system so callous as to not allow marijuana or morphine to be available to them. Laws against growing one’s own hemp is a modern development, but utterly totalitarian. However, Westerners have been so brainwashed that they choose to remain blind to the fact that it’s all propaganda to maintain the status-quo of the fat-cat establishment.

29

Way to go, Wildest Bill. You’ve got Jally in your corner now!

Meanwhile, I’ll just close up shop, and let the drug company advertisements educate everybody enough to diagnose their own conditions and choose their own drugs. But I’m not bitter. No, not bitter at all. “sniff”.

30

First, a warning: Call me a “freedom-hating soul” again and I’ll kick your virtual behind up around your ears. Go look-up some of my posts here in GD, I’ll wait.

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Right. Now to continue…

As stated before, those drugs which can be safely made OTC, are made OTC, but not until they’re really damn-well understood. Thalidomide, fer instance, (or Phen-Fen, or any number of others) cost on the order of 100s of millions of dollars in medical injury, even after clinical trials and FDA approval. That’s item One of why drugs aren’t just released to the public. Second, the probability of increased medical injury due to self-medication is astronomical, which injury will result in either raised cost of healthcare, or limitations of re-embursable treatment. Third, which has already been discussed to death, self-medication has health and life implications for everyone, not just the self medicators.

So, again, if it costs you some dollars to visit a trained professional to obtain a prescription, tough. I’m not willing to have my access to healthcare that I can afford limited to suit your whim, nor am I willing to suffer the other health risks associated with open access to Ethical Pharmacueticals.

Did you mean “there are no posted cites for the costs of brain injury”? If that’s what you were trying to to say, then, yes, they were posted, in the same post of mine which you quoted. Go read the sources. I’ve plenty more if you want them, or look them up yourself: They’re only a ‘Google’ away.

As for the cost of seeing a physician for prescription vice self-medicating, to the best of my knowledge, that study’s never been done, nor can I think of an ethical way of even conducting such a study without violating the Helsinki agreement.

Let me be crystal clear here:

If you want to take a risk with your life and/or health, be my guest, as long as that risk doesn’t impact me. As soon as your behavior begins to have a negative impact on me and mine, your ‘rights’ come under regulation.

And even if you are a paragon of thoughtful and educated virtue, laws aren’t written to the individual, they’re written to the expected behavior, across the population. That’s one of the aspects of our current Social Contract, and like it or not, it’s not changing any time soon.

31

Bumping this thread to mention a scary new article in this week’s American Prospect (“Epidemic Proportions”, by Saumya Das) about this very problem of indiscriminate antibiotic use, esp. in Third World countries, assisting the development of multidrug-resistant strains of disease. It could not be clearer that all of us are basically walking petri dishes for micro-organism evolutionary experiments, and that the more we use antibiotics, the greater the chances of developing drug-resistant versions even of the diseases that we thought we had conquered (as we’ve already done with TB and gonorrhea, for example). This is definitely not an issue that I want to see left to the discretion of individuals like the OP.