Hospital drug shortages, cont’d

by Walter Olson on March 4, 2011

I’ve got a new post up at Cato at Liberty on the avoidable medical crisis brought about in part by an FDA crackdown — and how the government might manage to make it still worse. I quote commenter “Greg S.” from our earlier thread (& White Coat).

{ 11 comments }

1 petty booszwha 03.04.11 at 3:53 pm

I believe part of the problem was exposed on 60 Minutes a few months ago — egregious sanitary violations at drug manufacturing facilities in Puerto Rico finally resulted in the permanent closing of factories there. These factories were built due to the work of Senator Bill Bradley granting outrageous tax breaks to pharmaceutical companies to move manufacturing operations there.

2 Bumper 03.04.11 at 5:56 pm

No problem, just go online and order your drugs from a pharmacy in Canada.

Oh wait, congress says we can’t do that. Never mind.

3 david 03.05.11 at 12:01 pm

Have you ever considered why we have to see a physician in order to get medication?? As a physician, I find it absolutely rediculous and contrary to a free society for the government to force people to see a doctor in order to obtain pain relief or antibiotics or any medication that they desire. This principal first came into play in 1913. The US was the country that came up with the concept. Prior to that, you could buy anything that you desired. The AMA was actually against the ban. We need to return to this concept and eliminate the government control of medication. This would not add any additional addicts to the roles.

4 Bumper 03.05.11 at 2:25 pm

“This would not add any additional addicts to the roles.”

Shirley you jest? The only possible way this would not happen would be if they self-medicated themselves to room temperature in such numbers that it self-limited the size of the rolls. My own experiences do not lead me to conclude that addicts have much self control. Which is possibly why they are called addicts.

Under most other circumstances I would agree with you, but the unfettered availability of most of today’s medications would have a negative impact on society. This is NOT to say that a total restructure of the FDA would be a bad idea.

5 Ben S 03.05.11 at 3:57 pm

“antibiotics”

As a physician, I’m sure you’ve heard of MRSA.

6 nevins 03.05.11 at 4:15 pm

David, in 1913 there were damn few medicines that would fit the modern minimal FDA hurdle of being effective. Most of what was then prescribed or recommended by a physician was folk medicine that was little changed from the raw products that had been used by healers for centuries.

Modern medicines are expensive, have myriad side effects, and are designed to treat conditions that the vast majority of folks should not attempt to manage on their own. The trained prescriber as gatekeeper for medicines with substantial potential downside, or are associated with complex conditions is a rational approach. When drugs are safe for the average non-medically trained person to use the drug maker is free to seek the broader market of over-the-counter sales by applying to the FDA for this status.

And as Ben observes, antibiotics are already massively over-used with the prescriber gatekeeper model, with resulting problems for everybody through antibiotic resistance. OTC antibiotics would be a major fail in policy.

7 david 03.05.11 at 6:07 pm

To expound on my comment. We have just as many addicts now as we did in 1913. The control of drugs has done little to alter the situation. Morphine, opium, cocaine were all available in 1913. We do have a number of additional drugs at present, but placing them at the disposal of the public would not cause any more harm than currently in the hands of most physicians that I know. As to MRSA, that has developed with doctors prescribing the drugs in an indiscriminate manner. What is the difference between a lay person taking the drug and a doctor giving it to them without thought to the consequence? If you think that you can practicie medicine and withhold antibiotics as per guidelines, then you have never been in practice.

The fact is that by turning control of one’s medical treatment back over to the individual, it would solve a number of problems. Doctors would no longer be the subject of rediculous malpractice actions, the saving from elimination of the DEA, half of our prisons, reduction in courts, etc. would be enormous.

8 Bumper 03.06.11 at 2:13 am

David, you speak like a true Libertarian, and for that I applaud you. However, I don’t believe you are right. Perhaps we have the same percentage of addicts today as in 1913 ( I doubt it, but since I am too lazy to look it up I’ll give you that one ) but not much else is the same. The population of America is two, three times what is was in 1913. The drugs are more powerful, cars are more powerful, towns are closer together.

On a whole todays population is probably the dumbest we have ever had and the least likely to take responsibility for their own care. And there is a world of difference between self-diagnosis and self-medicating and if you can’t see that there is nothing any of us can say to convince you otherwise. Your view is just plain unrealistic. PERIOD.

With regard to reducing lawsuits, this is only going to move them from the doctors lap into the pharmaceuticals manufacturers lap. Worst case they would quit making drugs that get them sued. Would would probably be all since even aspirin has side effects.

With regard to MRSA, I believe Norway is the poster child here. They don’t even let the super drugs in the country and guess who doesn’t have the MRSA problem. If we wanted to stop it we would have the take all the silly antibiotic soaps, etc. off the market, take the antibiotics out of the food chain and quit pissing these little critters off. They are smarter and faster than we are, but there is no money to be made there, so it ain’t-a-gonna-happen.

You have good ideas, but they are unrealistic all the same.

9 Le Mur 03.06.11 at 12:51 pm

The fact is that by turning control of one’s medical treatment back over to the individual, it would solve a number of problems.

You’re completely correct. It’s funny ‘n’ sad, but understandable given the years of relentless hysterical propaganda, how many people think it’s scary to let Those Other People have the freedom to run their own lives.

10 David Schwartz 03.07.11 at 6:35 am

“And as Ben observes, antibiotics are already massively over-used with the prescriber gatekeeper model, with resulting problems for everybody through antibiotic resistance. OTC antibiotics would be a major fail in policy.”

Don’t you think it’s a bit ironic that a policy’s massive failure is being used to justify that policy? OTC and prescriber gatekeeper are not the only models. For example, a very logical model would be for those with a financial interest in keeping antibiotics effective (such as those who hold patents to new ones) to be the gatekeepers.

11 GregS 03.07.11 at 12:04 pm

Hey, Walter quoted me. Great!

Regarding the suggestion that antibiotics should be available without prescription. I know this sounds bizarre and dangerous to us, but there are actually modern nations today where this already the case. I have friends from the former Yugoslavia who tell me that over there, even today, no prescription is needed to buy antibiotics. So rather than just rejecting the suggestion automatically, perhaps someone should examine how this works out in practice in places where it already exists.

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