Posted by
Andrews on Saturday, December 19, 2009 6:44:53 AM
I know many of my readers are bored with my harping on the war on drugs ("
Drug Legalization"), and most don't agree with me at all about the need to eliminate prescription laws( "
Medical Regulation II"), but I want to point out that, while we are complaining of high costs, especially of pharmaceuticals, I would like to point out the incredible waste that our drug paranoia and prescription laws force upon us.
At first I had intended to write of only one sort of waste, but then a second came to me while writing. However, in the interest of getting this article going, let me start with my original thought, the disposal of medications. You see, when a patient dies, or no longer needs a medication, the remaining medicine, even if unopened, even if it is a full course of treatment, is destroyed. Because our prescription alws prevent any medication from being transferred, when a patient has unused medicine, a nurse has to flush it or wash it down the sink. This is especially true for pain killers, as the government has a paranoia that someone, somewhere might get unauthorized pain relief or enjoyment. (So much so that those of us who truly need pain relief often fail to get it, and that doctors who prescribe pain medicines are under almost constant investigation -- see the postscript to "
Standing By My Principles".)
The reason I mention this is that, in the quest to eliminate "waste" not once has anyone suggested loosening our prescription laws or rolling back the war on drugs, even though it entails truly huge waste of pharmaceuticals every year. Drugs which could be reused, returned, resold, or even donated by the patient or family, are simply destroyed. For those seeking "waste" this should be an obvious target. Instead they look at having multiple insurance forms. I can't figure it out.
And, this waste when a patient goes off of a medication, for whatever reason, is not the only waste.
Because of our controls, any given vial of medicine in a hospital has to be assigned to only one patient. This sounds simple enough, but it entails more waste than you would think. For example, Ativan comes in 2 ml vials. Let us say several patients routinely get 0.5 ml. Each is given his own 2 ml vial, of which 0.5 ml is injected and 1.5 ml dumped down the sink, so that no one might illicitly enjoy it. Were we less paranoid, 4 patients could use one 2 ml vial, rather than four, cutting drug costs by 75%. Yet that would, of necessity, go against the war on drugs philosophy. (It would also reduce the amount charged those patients, making their hospital stay cheaper and reducing complaints about hospital costs.)
When I mentioned this, my wife suggested that there would still be a move to use individual vials due to risk of contamination, but I think that is unlikely. The reason being that in mass vaccinations, at least before thimerosal scares made the necessary preservatives politically unacceptable, there were multi-use vials used for inoculations. So long as the top was sterilized and a sterile needle used each time, no one worried about multiple use from a single vial. So why would different rules pertain when it is Ativan? Or other pharmaceuticals? (Excluding any that might be sensitive to exposure to light or air.) Of course, hospitals could choose to use individual vials, but then others could choose to reuse, and charge less. (Unless JCAHO forced one decisions, but that is the problem with government and pseudo-governmental regulation, and is another post entirely.) My point being, this should be an option to reduce costs, rather than cut off entirely by absurd regulations based upon protecting people from themselves.("
Man's Nature and Government","
It Doesn't Matter to ME...","
Trusting Mankind")
And with that, I will once again descend from my drug decriminalization, anti-regulatory soap box.