A recent proposal by the Food and Drug Administration illustrates the difficulty of improving access to health care while lowering - or at least containing - costs.
The FDA soon may allow Americans to obtain some medicines - such as those used to treat asthma or high cholesterol - without a prescription. The theory is people with conditions such as diabetes or high blood pressure could save the time and cost of visiting a doctor. After a consultation at a pharmacy, they could just buy the medicine over the counter.
While physicians question the wisdom of such a move, and pharmacists debate how they would handle it, their patients and customers can ponder whether this would save them money or merely shift costs around.
People who are covered by health-care plans or Medicare often have help paying for prescription drugs; however, medicines available without a prescription might not be covered.
Thus, out-of-pocket expenses could exceed money saved by foregoing a doctor's visit. On the other hand, Medicare and health insurers - and, by extension, taxpayers and those who pay for health coverage - could save money.
The FDA proposal underscores the point that expanding access to health care is relatively easy; managing the costs of doing so is much more challenging.