Writing in The Atlantic, Megan McArdle analyzes the societal cost of requiring a doctor's visit to get a prescription for Sudafed, in order to make it harder to acquire materials used in fabricating meth. She makes a compelling case that, as bad as meth labs are, and as much as they cost society, cracking down on basic, useful medicine also entails horrendous expense.
But this is sort of a side issue. What really bothers me is the way that Humphreys–and others who show up in the comments–regard the rather extraordinary cost of making PSE prescription-only as too trivial to mention.
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.
Do We Need Even Tighter Controls on Sudafed?
(Image: Project 365 #121: 010509 The Spy That Came In With A Cold, a Creative Commons Attribution (2.0) image from comedynose's photostream)