Posted on: April 2, 2009 3:55 pm

A prescription for condoms?! What size?

Our federalies want us all to have good quality, readily available healthcare. Who doesn't? Healthcare costs are ridiculously high and we must find a way to reduce the cost. Naturally government thinks they can turn the efficiency knob such that we all get the needed coverage at a lower cost. This is where people tend to start getting off the band wagon citing previous attempts like social security, medicare and medicaid that have failed to deliver the panacea of social promise. Everyone on board so far?

So the idea of national healthcare has been advanced and a plan is in place to drive us irrevocable in that direction. We have protagonists citing successes in France, Great Britain, and Canada. We have antagonists citing failures in France, Great Britain and Canada. What to do? Who to believe?

Mistress Smorgie is not afraid to advance a notion, nay a plan, to greatly reduce medical costs. And get this, it is simple! And I can guarantee success! I know, I know. Our well earned pessimism prevents us from getting on board. But I will give it a try anyway and I will base it on a bit of data to make you all feel better.

Everyday in every doctor's office around the country there are tens if not hundreds of patients plunking down money to see their doctors in the so called office visit. Let's assume it is no more than 10 patients an hour per doctor in the facility - so 80 patients per day. Let's assume the doctor charges $100 a visit (might be high but it makes the math easy). If you have insurance you may have to pay something like $25 or $30 bucks out of your pocket and your HMO or other insurance picks up something less than the balance. So for every doctor in the building it is conceivable to raise $8000 a day. If the facility has 5 doctors and they achieve 100% utilization they can generate $40,000 a day in billable sales. That is a whole bunch of money in a year and totals something over $10 million before taxes, wages, overhead, etc.

But for what? Let's assume we have a general practitioner office with 5 doctors and no shortage of patients ringing our phones. What percentage of those folks are showing up because they are sick? Let's say 50% are showing up because they have something wrong. What percentage of these folks know what is wrong with them? To be simple, how many know they have a fever and a cold? Or a very sore throaght? Or poison ivy? Or a bladder infection? Or an ear ache? You get the point. We know what is wrong with us usually. And we know what the treatment will be. Ear ache or strep - amoxicillan. Bladder infection more antibiotics, poison ivy - methylprednisone, pretty simple so far. Why not make these medications semi-over the counter? Meaning why not let the pharmacist dole out these types of medications as they see fit, skipping the doctor's office visit. When they come up on something that is above their call they can refuse to dispense the meds and advise you to see a doctor.

Want a great example? The yeast infection (sorry guys). We women know we have one immediately. No doubt. Not too long ago we had to go to the doctor everytime to get a prescription for a medication we know we need. Fortunately the powers that be (feds) made these medications over the counter so we could stay out of the doctor's office. Have you heard of anyone becoming addicted to Monostat 7 in the last decade? We women are not abusing the system.

In some European countries you do not need a prescription for eye glasses or contacts. You just pick up the corresponding set right off the shelf. And why not? Is there any benefit in wearing the wrong kind of glasses? Who wants to do that? I like mine blurry so I think I will get these. That is garbage. You still have to go to the optometrist to make sure you are healthy and to find out what your eye condition is. But beyond that, you should be responsible enough to pick them out. Think of it like this. To buy new wiper blades for your car you have to go to a mechanic to tell you what size you need and then you go the autoparts store and present your prescription for wiper blades. Not the same? Wiper blades help you with your vision don't they. OK maybe it is a stretch. Imagine if condoms were by prescription and some of you boys had to get measured - extra small for this one, ouch!!

The point is people should be able to be responsible for picking and choosing medications they need in the more mundane cases. Not the fancy life threatening variety to be sure.

But why do you need to pay $100 to have the doc take one look at you and scribble something out on a pad of paper when you already know what you need.

OK - you don't feel comfortable self medicating (I doubt that - think aspirin and a lethal dose). Remember, the pharmacist is more than capable of deciding who should and should not have amoxycillin or prednisone, et al. These are the facts.

So a simple way to cut costs is to make more medicines available over the counter or at least semi-OTC where the apotheke or pharmacist doles it out.





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