As I was fixing the wiring in my basement, a thought popped into my head about another way to decrease costs of medical care in this country.
Get rid of prescription requirements for most medications and procedures.
How many people would go to the doctor for a sore throat if they could buy a strep test over the counter? If the strep test is positive, they go to the pharmacy and purchase some penicillin over the counter.
If you twisted your ankle and could walk into a radiography center and get an x-ray of your ankle for $100, would you bypass the emergency department?
If you could buy your blood pressure medication over the counter, would you keep going to your doctor for those $150 checkups? Would you even purchase routine insurance? Or would you stick with just “major medical” coverage?
I know that issues would have to be worked out with an open access system – such as preventing narcotic abuse and preventing antibiotic resistance due to people taking Zithromax for the flu or Levaquin for their coughs. Maybe we’d have to limit the number of CT scans or angiograms that someone may receive to keep down the radiation doses.
You can purchase an HIV test or a pregnancy test over the counter. Why can’t you purchase a strep test or mono test over the counter? It’s not uncommon for medications once available only by prescription to go “over the counter.” Look at all the acid blockers and at Prilosec as one example. Why shouldn’t most prescription medications be available to everyone over the counter? If it isn’t a controlled substance, people should have access to it. What harm is avoided by having a medical provider as a “middleman”?
In almost any other situation, if I choose to take care of a problem myself, I can do it.
If I want to cut my own hair, I get a pair of scissors, look in the mirror, and start hacking. I don’t need a stylist’s prescription to purchase scissors.
If I want to sue someone, I can go to court, fill out the papers, pay the filing fee, and play the lotto. I don’t need a lawyer’s OK in order to gain entrance to the court house.
If I need to fix an electric outlet, I can go read about it online, buy the stuff at Home Depot, then hope I don’t get the red and the blue wires mixed up. I don’t need an electrician’s permission to purchase conduit.
When I get in over my head doing any of these things, I either take my chances or I call someone who knows more about the problem than I do.
Why should medicine be any different?
Think about it. If everyone had open access to medications, medical testing, and radiographic studies, there would no longer be an issue of what is and is not “necessary.”
If a patient wants a test, then the patient purchases the test.
If a patient wants medication, then the patient purchases the medicine. Be a lot fewer “designer” prescriptions being filled if patients had to pay full price for them.
With patients obtaining their own tests, there would be less medical malpractice for failure to order testing. The patient wouldn’t need a doctor’s order to get the test. Worried about breast cancer? Go have a mammogram done. Worried about lung cancer? Go get an x-ray … or a CT scan for that matter.
If patients get in over their heads, then they can seek the advice of someone who knows more about the problem than they do.
Until then, I say let people have at it.