It's Easier To Go After The Cold Sufferers Than The Meth Makers
The Atlantic's Megan McArdle goes after the asshattery in behind notions that it's okay that you'll suffer from cold symptoms -- as long as somebody's prevented from getting Sudafed to make meth. One suggestion is that states do as South Carolina has and make Sudafed prescription only:
Let's return to those 15 million cold sufferers. Assume that on average, they want one box a year. That's going to require a visit to the doctor. At an average copay of $20, their costs alone would be $300 million a year, but of course, the health care system is also paying a substantial amount for the doctor's visit. The average reimbursement from private insurance is $130; for Medicare, it's about $60. Medicaid pays less, but that's why people on Medicaid have such a hard time finding a doctor. So average those two together, and add the copays, and you've got at least $1.5 billion in direct costs to obtain a simple decongestant. But that doesn't include the hassle and possibly lost wages for the doctor's visits. Nor the possible secondary effects of putting more demands on an already none-too-plentiful supply of primary care physicians.Of course, those wouldn't be the real costs, because lots of people wouldn't be able to take the time for a doctor's visit. So they'd just be more miserable while their colds last. What's the cost of that--in suffering, in lost productivity?
Perhaps it would be simpler to just raise the price of a box of Sudafed to $100. Surely that would make meth labs unprofitable--and save us the annoyance of a doctor's visit.
They can still buy cold medicine, protest the advocates for a prescription-only policy. But as far as I can tell, there's really no evidence that the current substitute, phenylephrine, does a damn thing to ease congestion; apparently, a lot of it gets chewed up in your liver pretty quickly, and because the FDA only allows a low dose to start with, the resulting pills don't seem to be any better than placebo. For people who are prone to sinus or ear infections, that's no joke; one of the main ways you prevent them is by taking a decongestant as soon as you feel the first ticklings of a cold--not four days later, when your GP can finally see you.
Obviously, the suffering of someone caught in a meth lab is much, much higher--but how many of these people are there? Should we deny millions of people a useful treatment in order to prevent a handful of fatalities? Before you answer that, ask yourself whether you'd be willing to stop driving on the grounds that statistically, you're reducing the chances that someone will die. Or to endorse a policy that involved punching 15,000 people in the head, hard, in order to prevent one death.
Perhaps it's unfair of me, but it seems to me that there's a lot of tunnel vision in these proposals. People who present prescription programs as simple and obvious seem fixated on the horror of the stories they are confronted with . . . to the exclusion of the very large costs that they're proposing to impose on the rest of us. All they're interested in is "how do we put an end to meth labs?", a question to which one can reasonably argue the answer is "better control of pseudoephedrine"**.
But no policy question is ever as simple as "How can we stop X", unless "X" is an imminent Nazi invasion. We also have to ask "at what cost?" and "by what right?"
The "prevention" here is via TSA-style logic: Search every granny and 6-year-old little girl who comes through the airport and you might one day find a terrorist. The intelligent airport security proposition: Keep your latex-gloved paws out of granny's diaper and hire highly trained, actually intelligent intelligence officers to use targeted intelligence on people who show probable cause to be considered suspects.
Same goes for meth. Follow the meth back to the hole...don't make everybody with a stuffy nose take a day out to go to the doctor -- or go to work sick and leak nose germs all over the damn place. Ick.







Maybe someday we can go back to defining profiling as "description of the suspect".
RRRoark at February 7, 2012 12:09 AM
Most cold medicines today suck. NyQuil works pretty well, and aspirin. I don't bother with anything else OTC. The drug war has made OTC drugs worthless to me.
MonicaP at February 7, 2012 6:31 AM
Amy Alkon
https://www.advicegoddess.com/archives/2012/02/its-easier-to-g.html#comment-2963604">comment from MonicaPThe form of Mucinex that you can go and buy without having your ID recorded by the state (the one on store shelves) is pretty worthless for its said purpose.
Amy Alkon
at February 7, 2012 6:34 AM
I have pretty bad allergies to various things floating around in the air here in central Texas- the severity varies year-to-year, and this year is a bad one. As soon as I get the sniffles I get the GOOD Sudafed- the kind behind the counter. If I don't, it's all downhill. First I get a sinus infection, and then I usually end up with an awful cough and upper respiratory issues. I hate, hate, hate going to the doctor- I don't do it unless I'm dying.
While I get that states that have a Mullett problem might also have a Meth problem, I still wonder: Do that many peole really do meth? My theory is that people who do that kind of drug (the really dirty stuff like meth or crack or heroine) are going to find something to get f*cked up on, no matter what. Normal people don't decide to go home and cook up a batch of methamphetimine in their kitchens just because the ingredients are available, just like normal people don't typically huff paint or do whippets off of ReadiWhip cans.
ahw at February 7, 2012 7:44 AM
I am VERY prone to respiratory and ear infections.
After years of having to see my doctor to get prescription-strength medicines that half the time they wouldn't give me because cough syrup with codeine is "addictive" and the government likes to crack down on doctors who give powerful medicine to people who need it, I gave up. I switched to herbal teas and poultices as well as large doses of vitamins C and D.
The Original Kit at February 7, 2012 7:59 AM
Did you know that you can take unpasteurized apple cider, put in a little sugar and yeast, and make Deadly Alcohol?! My god, what if a CHILD got into that??!
Steve Daniels at February 7, 2012 8:23 AM
the problem is, as with any TSA logic, the govt just doesn't give a frell what citizens think. For this same reason they had to get rid of most types of asthma inhalers, and "reformulate". so now inhalers require a prescription, cost ~6 to 10X more, and aren't as effective. All to satisfy an unproven requirement to remove a propellant.
Rather than asking a pertinent question like: "how much CFC ACTUALLY escapes to the atmo? what is the tradeoff in actual health benefit for the asthma sufferer? It's not like hairspray where you are putting the propellant directly in the air. For this, you are inhaling it. When you exhale there may be a small amount expired, but how much is it?
Who cares? it's so much easier just to blanket remove. That is the theory at work here too.
SwissArmyD at February 7, 2012 8:41 AM
9 year old had cough last week. Had to show ID to buy Children's Vicks Cough Syrup. WTF?
Number of people I've seen come in our ER due to bicycle accidents: um, hundreds.
Number of people I've seen who cut themselves up on their lawn mower? At least two dozen.
Oh, and there were about 3,000 deaths last year caused by space heaters (fire).
About 5,000 people drown each year in swimming pools.
Why don't we just require that everyone encase themselves in bubble wrap and remain in padded rooms. Then nothing bad will ever happen! Sarcasm aside, I feel like this is where we're headed!
UW Girl at February 7, 2012 8:51 AM
I read this yesterday and wondered if we'd discuss it here. There's a real problem with the prohibition mentality that works on these situations - people who support the ever-tighter ratcheting of the security state in response to real horrors (meth labs, addicts, suicide bombers) focus entirely on those uncommon events, and disregard the small costs their policy preferences impose on everyone. There's no discussion of cost balancing; until we can do that, we're likely to be faced with more and more of these intrusions.
Christopher at February 7, 2012 9:11 AM
Amy:
Hey, wait wait wait.
The form of Mucinex that you can go and buy without having your ID recorded by the state (the one on store shelves) is pretty worthless for its said purpose.
Mucinex is great stuff. Guaifenesin.
Now, the Guaifenesin-*D* - where they've replaced PSE with PE in addition to the guaifenesin- that's worthless.
But guaifenesin kicks ass at getting mucus to thin out and move - which helps sinus congestions, trust me. I often take it at night to help when I'm having problems with allergies.
But the PE - that dose was approved *because* at that dosage there is *no noticeable effect*.
----
But the big reason here is so you spend thousands - tens of thousands to amass evidence and raid the meth labs and more money to clean it up and ... then what?
There's no *money* there. There's nothing to seize to make back up what you spent doing the long investigation and criminal case, and incarceration of the meth-makers, who almost always are pouring what they make right back into getting enough for them, too.
No. Money.
But DRUG COMPANIES, now they're rolling in dough. Even if we externalize the cost, and bother more people and lose productivity, it's no longer on the "state's" balance sheet.
Really, follow the money - and there's a lot to be said, sadly, for this thought process.
Before they passed all the PSE bullshit, 85+% of the meth came from Mexico, made in factories.
Now, 90% of the meth comes from Mexico (this is prior to PSE being illegalized down there, so all hell might be about to break loose).
(Hell, for a Government program to get a 5% improvement is a massive surprise to me and worthy of some positive thought! Even as many billions as we spent to do, basically, nothing other than annoy law-abiding people with jobs and duties that require them to face timelines, etc.)
(As a gun owner, the annoying law-abiding people part makes me chuckle. Welcome to our world, assholes. Not quite what you learned in "Civics class", isn't it? Now shaddup and fill in the form and circle here and fingerprint here and smile, because it's For Your Safety.)
Unix-Jedi at February 7, 2012 10:00 AM
Husband works for a defense company. I found out that they have an on-site clinic. He has a cold and wanted to cough drops. To get a cough drop, he had to sign two documents: proof that he was an employee, and a waiver of liability for the cough drops. Considering that they have guards and whatnot to enter the facility and parent-kid day consists of staring at dad's empty cubicle, seems a bit preposterous to think that a non-employee can make it to the clinic. Then he had to get his blood pressure taken and been seen by the nurse.
Nurse tried to give him 5 cough drops. He said for all that, they needed to give him a lot more than that.
NikkiG at February 7, 2012 10:04 AM
The Economic Way of Thinking about Politics
12/03/07 - Russell Roberts at Econlib
=== ===
[edited] Politicians are just like the rest of us. They find it hard to do the right thing. They claim to have principles, but when their principles clash with what is expedient, they often find a way to justify their self-interest. If they sacrifice what is noble or ideal for personal gain, they are sure to explain that it was all for the children, or the environment, or at least for the good of society.
Bruce Yandle uses bootleggers and Baptists to explain what happens when a good cause collides with special interests.
When the city council bans liquor sales on Sundays, the Baptists rejoice. It is wrong to drink on the Lord's day. The bootleggers rejoice too. It increases the demand for their services.
The Baptists give the politicians cover for doing what the bootleggers want. No politician says we should ban liquor sales on Sunday in order to enrich the bootleggers who support his campaign. The politician holds up one hand to heaven and talk about his devotion to morality. With the other hand, he collects campaign contributions (or bribes) from the bootleggers.
Yandle points out that virtually every well-intentioned regulation has a bunch of bootleggers along for the ride, special interests who profit from the idealism of the activists and altruists.
=== ===
Andrew_M_Garland at February 7, 2012 11:30 AM
Prohibition didn't last nearly as long as the war on drugs. Are we more stupid now?
MarkD at February 7, 2012 12:01 PM
Prohibition didn't last nearly as long as the war on drugs. Are we more stupid now?
It's not necessary to answer whether are more stupid now to address this. Repealing Prohibition meant going back to the status quo ante, and everyone drank before (and most were drinking during). Ending the war on drugs is rather different, in that drugs never have had the social legitimacy of alcohol.
Christopher at February 7, 2012 12:23 PM
Govt is inherently lazy. It is hard to prosecute meth lab cases. It costs money and resources. Govt makes the laws so it is easy to effectively ban Sudafed.
This is also the source of school zero judgment policies. It is easy to adopt a "zero tolerance" policy about firearms, so children get caught up in the bureaucracy for making the shape of gun with their hand. It hard to take disciplinary action where you actually have to prove facts.
BTW Doctors also are tyrants. In my state I have to have a prescription for Sudafed. This is an over the counter medication, but my Doctor won't prescribe it unless I go in for an office visit. After all I am too ignorant to self medicate an over the counter medication.
Bill O Rights at February 7, 2012 3:00 PM
To Bill O Rights,
Sudafed may be safe to self-prescribe, but your state politicians have stupidly made it a prescription drug.
The doctors are caught in the middle. A doctor can't just write a prescription; he would be liable for any bad outcome or interaction with other drugs. So, he has to do a workup to rule out admittedly unlikely situations.
Andrew_M_Garland at February 7, 2012 4:58 PM
I've said here before that the government's goal here is to eliminate all availability of over-the-counter drugs. Lots of special interests are going to rake it in when you have to go see the doctor for an aspirin.
Cousin Dave at February 7, 2012 6:11 PM
Remember: this is the situation guaranteed by Federal health care.
-----
On another note - where is the demand that meth be legalized?
Radwaste at February 8, 2012 4:36 PM
"where is the demand that meth be legalized?"
Those rallies tend to last 36-48 hours, so they have a hard time getting permits.
Unix-Jedi at February 8, 2012 8:02 PM
Actually Christopher, it did.
Cocaine used to be an important ingrediant in Coca-Cola, hence the name.
It was also proscribed as a treatment for alcoholism.
Opium was also once used to treat alcoholics, so that they would be less of a social menace. Some alcoholics would be violent and dangerous while intoxicated, an opium user takes a nap.
Weed was used for centuries without issue.
LSD was used by researchers to help lower their "logic filters" if I remember the term correctly, and is actually responsible for the discovery of the double helix model for DNA. (Of course that guy eventually went crazy)
The list goes on, Sears catalogues used to carry drug paraphenalia and ship it through the mail.
Most of this stuff was legal into the 19th century and a fair chunk of the 20th.
Its not that we're dumber though, its that we're more cowardly. Nervous nellies weren't that common once upon a time, now they're the new normal.
Robert at February 9, 2012 7:51 AM
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