Dare to Dream: Over-the-Counter Birth ControlS

As the FDA considers making it less of a pain in the ass for people with chronic ailments to get their meds, some health care advocates think now might be the time to lift the prescription requirement on another daily pharmaceutical that must be endlessly renewed: birth control. But without a doctor to look at them disapprovingly, how will sex-having ladies know to feel bad about themselves?

Yesterday's FDA panel discussion didn't center on birth control; rather, the agency considered whether it made sense to remove the prescription requirement on certain chronic conditions in order to alleviate costs for patients. Eliminating routine prescription-renewal doctor visits for people with asthma, high blood pressure, migraines, and high cholesterol can save consumers more than $100 billion annually by some estimates. Plus, it eliminates the actual need to go to the doctor and sit in the waiting room reading a People magazine from three weeks ago, which is a pain in the ass.

Some birth control advocates see this discussion as an opportunity to work toward even wider accessibility of hormonal contraception, and today, during the second half of the public hearing, the FDA may discuss prescription-free birth control.

Here's how it might work, in an imaginary America that was able to talk about sex without giggling or flushing with deep seated sexual guilt that's taken decades to fully install: let's say you're a woman who wants to get to sex having, and doesn't want to get to breeding. You'd wander into your local Walgreens or Duane Reed or CVS, skip past the oversized display of poor-quality holiday-themed hand towels and jar candles, and casually sidle up to an automated touch screen that's there to act like a pixelated doctor that never goes golfing. The kiosk would ask you a series of questions about your health history, your prescription history, and whether or not you smoked. Based on your responses, the machine would let women know whether it was advisable for them to take hormonal contraception.

But don't get to planning a giant Birth Control Huffing Party yet for all your doctorless friends; the proposal has some vocal opposition. The American Medical Association doesn't like this idea at all, or the idea of anyone being able to get a prescription without seeing a doctor first. The AMA says that circumventing a doctor's expertise is inadvisable because patients could endanger themselves, but anyone who has been to a health care appointment that consisted of waiting for 45 minutes and then seeing a doctor for 5 would probably struggle to find a difference between the expertise of a doctor and the expertise of a machine that asks you the same questions. At least the machine makes eye contact.

And, of course, social conservatives will figure out a way to make this about religious freedom. How do we know that the machines aren't morally opposed to dispensing birth control? How do we know they're not Catholic?

Doctors pressure FDA for nonprescription birth control pills [Bloomberg]