> This is a deeply weird take. You think anyone ought to be able to buy, for instance, warfarin and freely take it without a doctor’s involvement? We should let parents self-diagnose diabetes and administer insulin without a prescription or discussion? We should just hope that patients heard their doctor say hydralazine and not hydroxyzine?

Weird examples. You can buy insulin without a prescription today in the USA.

In much of the world -- including almost all of Asia, Africa, and much of Eastern Europe -- you can buy almost any drug without a prescription. The only exceptions are potent CNS stimulants or narcotics, and in some rare cases antibiotics.

This is legitimately a better system. Takes out the middleman.

In the US you can get any drug if you pay $120 and recite the magic words to a telemedicine "doctor."

Funny you mention this... I bumped into a VP of Merck at a conference and that's the exact example he gave: in the US, you can't adjust your own coumadin dosage without a M.D. consult, but here, have 200 doses of insulin to take home with you.

In much of the world -- including almost all of Asia, Africa, and much of Eastern Europe

Doctors in the US get a nice $200 to $500 per doctors visit, required to extend the prescription drug. I only notice because I pay cash. This is why they will argue against anything I am saying until they are code-blue in the face. I will leave them with my code brown.

In the US you can get any drug if you pay $120 and recite the magic words to a telemedicine "doctor."

That's how a number of us in a particular circle stock up on anti-biotics. That said anti-biotics are a last resort for me whereas I find doctors are quick to prescribe them.