August 07, 2007

Publix supermarket chain said today it will
make seven common prescription antibiotics
available for free...
---News Report, South Florida Sun-Sentinel,
August 7

Well, isn't this just dandy? Florida Governor Charlie Crist certainly thinks so, so much so that he "went to a suburban Fort Meyers store to help the company make the announcement..." Now, it's not quite clear what kind of "help," precisely, was needed by Publix in an announcement of free pills, but never mind. Crist is hardly the only politico known to take credit for the generosity of others, but---let me be blunt--- his observation that "It can't be any more affordable than free" is infantile even by normal political standards.

But never mind that either. Let us consider instead a few implications of "free" antibiotics less than entirely salutary. Since the usual suspects love to assert that drug advertising leads patients to pressure their doctors for inappropriate prescriptions---a claim far from obvious and not consistent with the available evidence---it follows that free antobiotics will lead to overuse, increasing drug resistance for various pathogens, and thus medium-term outcomes for which neither Crist nor any other politician will be anxious to claim credit. At a minimum, it is not hard to predict that both doctors and patients, given a choice among alternative antibiotics available to treat a given condition, will be led to try the freebies first, thus skewing the mix of medicines used and so increasing the resistance problem.

And if commonly-used antibiotics can be free, why not other drugs as well? Thus will this little foothold lead to political and other pressures for things bigger, which might be applauded by such as Governor Crist, but which promise only increased sufferings over time as pharmaceutical prices are squeezed and the future development of new and improved medicines is reduced. So much for the children.

Nothing is free. The only question is which economic and social arrangements yield the maximum benefits for mankind over time. This particular "free antibiotics" stunt by a business firm is voluntary, that is, not imposed by government, and so is wholly defensible on its own terms, but that does not answer the larger problem of the use of political and regulatory processes to demonstrate "compassion" by spending other people's money. That is the larger implication of Governor Crist's enthusiasm for taking credit where he has earned none, and it is very unlikely to prove a happy one.

Posted by Benjamin Zycher at August 7, 2007 01:07 AM

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