The economic cost of the continuing war on my sinuses

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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.

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.

As the owner of an incredibly shitty set of sinuses, my solution to Sudafed being a controlled substance is that I buy one box a month whether I need it or not. If they change it to require a prescription, that's going to significantly impact my stockpiling efforts. (Does it ever go bad?)

And I can attest that phenylephrine does exactly two things, "fuck" and "all".

About that "punching 15,000 people in the head" thing: do I get to pick them? Because if so, yes.


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Scum and villainy.

Hit men, click whores, and paid apologists: Welcome to the Silicon Cesspool

It's tough being a journalist, especially if you're covering technology and living in Silicon Valley, because it seems as if everyone around you is getting fabulously rich while you're stuck in a job that will never, ever make you wealthy. What's worse is that all these people who are getting rich don't seem to be any brighter than you are and in fact many of them don't seem very bright at all. So of course you get jealous. And then you start thinking maybe you could find a way to cash in on this gold rush. But how do you make gobs of money when your only marketable skill involves writing blog posts? [...]

Well, this is the model I was thinking about, but it turns out someone beat me to it -- it's called CrunchFund, and in the past few days we've seen the machine in action, and it is indeed a beautiful thing. [...]

This is what now passes for "journalism" in Silicon Valley: hired guns and reformed click-whores who have found a way to grab some of the loot for themselves. This is perhaps not surprising. Silicon Valley once was home to scientists and engineers -- people who wanted to build things. Then it became a casino. Now it is being turned into a silicon cesspool, an upside-down world filled with spammers, liars, flippers, privacy invaders, information stealers -- and their grubby cadre of paid apologists and pygmy hangers-on.

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"Oh snap."

"Douchebag pundit is a douchebag" is not news, but this eight word smackdown within the response is a work of art.

Rob Beschizza wrote:

If you want to understand why Silicon Valley startups keep tripping into privacy-related PR disasters, you could not do better than reading this attack on online privacy from Silicon Alley Insider editor Matt Rosoff. [...]

By "normal" people, Rosoff means people like him, who must endure rather than hope for obscurity.

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Headline of the week:

Bound, naked in a Subaru: Valentine's Day role-playing ends badly.