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The key word is "prescribed". That means that in order to get this $4 drug to save your life, you have to go to a medical provider for a prescription. If you'

The key word is "prescribed". That means that in order to get this $4 drug to save your life, you have to go to a medical provider for a prescription. If you're poor, you likely will not have a normal doctor or dentist, and going to an ER could leave you with crippling debt. If you don't realize your problem is serious enough to kill you, the rational choice is to suffer until it clears up on its own. I'm not advocating that people be able to purchase antibiotics without a prescription -- that would lead to more drug resistance. However, I do think that states should consider allowing pharmacists to do more, such as allowing them to prescribe medications in "simple" cases like this. Pharmacists are the most underutilized medical professionals that we have, and using them more effectively could have a big impact.

maxerickson 9y ago
It's not necessarily simple though. For instance, lots of doctors would want to check for an abscess.
- LyndsySimon 9y ago
  The last time I had an abscess, I went to an urgent care. I paid cash ($80), told the doctor that I believed I had an abscess, and asked for a prescription for antibiotics since I was traveling and it would be at least a couple of days before I could see my dentist. He did a very cursory oral exam, wrote the prescription, and we were done.
  - maxerickson 9y ago
    So how do I get my money back from the hospital/doctor that did a CT scan to investigate my sinus infection at 4 AM? (I had a cavity on a tooth and the infection irritated that tooth so I had pretty good pain on that tooth and non localized pain along my whole jaw and also had never had such a painful sinus infection and went to the ER because I didn't understand why it was so painful. I bitched at them, they came back with "the doctor wanted to be sure there was no abscess". What really pisses me off is that having the radiologist do the diagnosis kicked the visit up to a more expensive billing code, because apparently it's complicated to do imaging and defer the diagnosis. They bill you to collect the information to make the diagnosis obvious and then bill you more because they collected more information.)
    - LyndsySimon 9y ago
      If you were confident that's what it was and were willing to take the risk, you should have refused the additional test. Doctor's advice is just that - advice.
      - maxerickson 9y ago
        My ramble above isn't all that clear, but I wasn't confident at all, I didn't understand why I had the amount of pain I did (hence going to the ER in the middle of the night). The point is the doctor wanted to check for an abscess.
        LyndsySimon 9y ago
        Of course he wanted to check for an abscess - an abscess into the sinus cavity can be a very big deal. Whether or not to perform that diagnostic is not his decision, it's yours. I think we're speaking to different things, though. I'm simply saying that there are ways for people without health insurance to obtain a prescription for an antibiotic without going to an emergency room and incurring a large debt.
        maxerickson 9y ago
        I'm not sure we are speaking to different things. I'm skeptical that a pharmacist would want to accept any liability to sell the $4 of antibiotics. The not simple part (my relating my experience is to argue that it isn't always simple). I wonder what the doctor you saw would do with someone less sure of their issue.
LyndsySimon 9y ago
> going to an ER could leave you with crippling debt You're right of course, but having grown up around people in this sort of situation, I'd like to point out that they view debt differently. It's exceedingly unlikely that a trip to the ER is the thing that destroys their otherwise decent credit, and it's unlikely that the collection agency that ultimately buys the debt will take them to court to collect as they don't have anything to put a lien against and may not even have an income to garnish. In other words "leave you with crippling debt" isn't nearly as scary to the people in that situation as it is to someone who isn't.

maxerickson 9y ago

It's not necessarily simple though. For instance, lots of doctors would want to check for an abscess.

LyndsySimon 9y ago
The last time I had an abscess, I went to an urgent care. I paid cash ($80), told the doctor that I believed I had an abscess, and asked for a prescription for antibiotics since I was traveling and it would be at least a couple of days before I could see my dentist. He did a very cursory oral exam, wrote the prescription, and we were done.
- maxerickson 9y ago
  So how do I get my money back from the hospital/doctor that did a CT scan to investigate my sinus infection at 4 AM? (I had a cavity on a tooth and the infection irritated that tooth so I had pretty good pain on that tooth and non localized pain along my whole jaw and also had never had such a painful sinus infection and went to the ER because I didn't understand why it was so painful. I bitched at them, they came back with "the doctor wanted to be sure there was no abscess". What really pisses me off is that having the radiologist do the diagnosis kicked the visit up to a more expensive billing code, because apparently it's complicated to do imaging and defer the diagnosis. They bill you to collect the information to make the diagnosis obvious and then bill you more because they collected more information.)
  - LyndsySimon 9y ago
    If you were confident that's what it was and were willing to take the risk, you should have refused the additional test. Doctor's advice is just that - advice.
    - maxerickson 9y ago
      My ramble above isn't all that clear, but I wasn't confident at all, I didn't understand why I had the amount of pain I did (hence going to the ER in the middle of the night). The point is the doctor wanted to check for an abscess.
      - LyndsySimon 9y ago
        Of course he wanted to check for an abscess - an abscess into the sinus cavity can be a very big deal. Whether or not to perform that diagnostic is not his decision, it's yours. I think we're speaking to different things, though. I'm simply saying that there are ways for people without health insurance to obtain a prescription for an antibiotic without going to an emergency room and incurring a large debt.
        maxerickson 9y ago
        I'm not sure we are speaking to different things. I'm skeptical that a pharmacist would want to accept any liability to sell the $4 of antibiotics. The not simple part (my relating my experience is to argue that it isn't always simple). I wonder what the doctor you saw would do with someone less sure of their issue.

LyndsySimon 9y ago

> going to an ER could leave you with crippling debt You're right of course, but having grown up around people in this sort of situation, I'd like to point out that they view debt differently. It's exceedingly unlikely that a trip to the ER is the thing that destroys their otherwise decent credit, and it's unlikely that the collection agency that ultimately buys the debt will take them to court to collect as they don't have anything to put a lien against and may not even have an income to garnish. In other words "leave you with crippling debt" isn't nearly as scary to the people in that situation as it is to someone who isn't.