For Your Own Good

Andrews,
I understand your comparisons, but I have to disagree with you. Granted, not all drugs that are out there should warrant an Rx. I love going to Europe because I have OTC access to some great stuff, but...
BC rx's are typically prescribed For a year after a lengthy health survey and a physical exam. Many women experience devastating side effects and don't realize it. There are real risks for many people that are unknown until they actually take the pill. It is a necessity to check that the rx is strong enough (or not) for the individual. Mine was so strong that my body acted pregnant and I didn't know any better. It hurt, believe me!
Working in the field of medicine, I have seen many women go through terrible things as a result of their rx's going unchecked. One patient, an obvious exception, took a low-dose pill that was not strong enough to suppress ovulation and became pregnant twice. Other women become subject to chronic yeast infections that can end up systemic as opposed to vaginal only and this creates a myriad of other issues for her to deal with.
Every six months really amounts to once a year. That is not unreasonable as a woman, especially one of childbearing age and anyone not in a monogamous relationship, should have a gynecological exam. It covers much more than you know...even if it does seem to you that the doc is self-serving.

I understand your argument, but you actually make my point. Women are prescribed the pills, THEN they are discovered to have a dose too low or too high. The same could be done without a prescription at all. If a woman bought the pills and then felt bad, she would go to her doctor. The same as happens WITH a prescription. I managed to almost choke to death on undigested food (among other side effects) for 4 months yet my doctor never suspected his prescription until I discontinued it against medical advice, so I think the "safeguard" aspect is a bit of a myth. (No, I am not drawing conclusions form one bad doctor, I had similar experiences with almost a dozen, and several emergency department. Though my beliefs here actually predate my health issues, the bad health just reinforced my preexisting beliefs.)

My basic argument is that prescriptions , in fact the entire FDA, is an unneeded bureaucracy.

Well, as I opened the whole can of worms, I suppose I should delay my writing and set down my whole anti-prescription/anti-FDA explanation (maybe my anti-AMA licensing rant as well).

I expect some strong disagreements on that one, but since I started I should probably follow through.

Thanks for your comments, hopefully you will be entertained by the follow-up article.

There is one thing you said that actually is a symptom of the problem of regulation.

"Every six months really amounts to once a year. That is not unreasonable as a woman..."

That is the same argument used for sugar tariffs and other bad ideas. "It is only 2 cents a pound, that doesn't matter to you."

The issue is not whether or not it is reasonable, but that a woman is FORCED to go to a doctor twice a year to be ALLOWED to buy birth control pills. That is still coercive. And unnecessary. As I said, no tests are performed BEFORE prescribing the pills, many doctors prescribe them gladly to new patients after a minimal physical and a few questions which could not possibly disclose any likely adverse reactions. So, again, why do we need the doctor to prescribe?

And, again, to you it may seem very little, but for the doctors it is quite lucrative. Several hundred patients times two, that is quite a nice annual supplement to their income from patients they might not otherwise see.

Which is the key to abusing government power. In this case or the sugar tariff case, to the individual consumer it is small, a few cents or "just 2 visits a year", but to the industry which benefits it is a huge boon due to the volume of consumers.

an Old dog can be taught new tricks, but old habits die hard!! I understand what you are saying, still, some things should not be left to the individual all the time. I realize there are quacks out there, no doubt. But the average American is not going to know as much as say someone like me or you who has gone through the ringer. I don't know if this example will show you what I mean...and naturally it doesn't excuse the bureacracy because I can tell you some great FDA approval stories...
A gal I know wanted desperately to believe in holistic medicine. She had been having back pain and decided the chiropractic route was good for her. Temporary relief, but absolute faith to keep going for 6 months, when another symptom appeared. Jaundice. Well, that is the only thing that got her to the GP. Last gyn exam several years gone by. Ovarian cancer killed her in 2 more weeks. Had she just gone for the yearly exams whether gp or Ob-gyn, she may be here instead of pushing up daisies. We all think we have enough knowledge to self-medicate when in reality, we get the tip of the iceberg. Not to say however that we couldn't make things simplified in terms of government and it's lousy bureacracy.

And I agree that people can make stupid choices. I have had to argue against many varieties of medical quackery friends and family have believed at one time or another.

My one problem is that the single centralized bureaucracy can keep out quacks, but it can also stifle valid theories which go against the present orthodoxy. Admittedly, quacks outnumber unrecognized genius by thousand of times, and I am not going to buy into the quacks' defense that there are millions of unrecognized geniuses out there toiling away. Far from it.

On the other hand, as I said, there are many areas of life in which we rely on competing private licensing and certification bodies and they work fine, while a single private certifying body can both quash new research, prevent effective but unorthodox approaches, keep out talented amateurs, and give unwarranted powers to a small group.

Wow, that was a lot to explain. Guess I will have to say read the article once I post it, as I know explaining all I said will go over 2000 words.

You are right. I myself believe that I could challenge the NCLEX for nursing and pass it with flying colors, but "credentialing" says I am not allowed.
Waiting for your expanse!!

As the husband of an RN, I can say that she thinks certification is something of a joke. As she puts it "I thought I knew what I was doing when I graduated, but I had to learn everything on the job." The test mainly tests some basic knowledge (some relevant, some not so relevant), but real practical experience is still gained on the job. The background is obviously important, you probably couldn't learn on the job without the background, but you can still pass the test and be a complete moron and a very bad nurse.

I think of it the same way I think of the bar exam. Anyone could take a bar exam prep and pass (provided they were clever enough), no need for law school. On the other hand, most people could not pass the bar exam with law school alone, as the questions tend to be a bit esoteric. (Many of us in law school thought the bar exam existed to [1] drum up business for bar exam prep teachers and [2] provide an entry bar, to keep lawyer salaries high.)

In fact, number 2 is the reason for licensing in a lot of fields (barbers, for example, or my state requires a license for door to door sales men! At least it is just an $80 fee, no test required.). The licensing rules exist to general small revenue streams for the state and to provide higher salaries for the profession by barring some competitors.

Well, that is another essay as well. I will try to write this week when work is slow, so hopefully you will have something to read very soon.