I can heavily empathize. In the last 4 years I've had at least 4 life-threatening infections. 2 of them related to dental health, 2 of them unrelated and both leading to temporary paralysis. I couldn't afford insurance and you know how expensive antibiotics are (and dental treatment, of course).
Each time I had to either resort to finding and buying antibiotics on the street or dying within a day or two. I feel so blessed to even be alive today that it brings me to tears.
And then I think about how CorpGov tried everything they could to prevent people like me from having access to healthcare, how I came within hours of death 4 different times and was not provided aid once, and how often this must happen to people who are not as committed and resourceful as I was.
I vividly remember being paralyzed on my bed, only being able to really move my left arm, literally watching an infection travel through my bloodstream as my veins turned red and inflamed, my lungs beginning to feel hard, crying to myself, and falling asleep not knowing if the antibiotics I had found only hours before would kick in and if I would ever wake up again.
That is the healthcare system in America :)
Yes, it may not be as bad as most of Africa's healthcare system, but our government repeatedly makes the claim that we are the best and greatest nation on earth, with unparalleled opportunity for its citizens. If we are going to make that claim, the claim that we are a 1st world country and not a 3rd world country, we have to be able to back it up.
Again, I'm NOT an apologist for the system we have, but I don't understand how it got to this point for you.
I had a bullshit drug conviction from high school when an underage and unlicensed driver rear-ended my friend and I and he had a small amount of pot in his booksack that I didn't know about. The case took two years and about eight appearances, six or so conflicting testimonials by officers present at the scene, and I was given the maximum penalty possible.
I couldn't get a decent job because of the charge and I was being extorted monthly for money by the government. I had no support from family and ended up taking what I could as far as housing arrangements, leading to me getting robbed about half a dozen times by various roommates over the years for a total of a few thousand dollars.
I was still learning CS in my free time so I was limited to part time minimum wage jobs and had no disposable income.
I developed heart palpitations and visited the ER, but they laughed at me and gave me a bunch of useless crap and scans related to my lungs, didn't look at my heart, then gave me a receipt for a sum that vastly outweighed what I was told I would be expected to pay. I was diagnosed with costochondritis, and amazingly, because I mentioned I had smoked marijuana before in my life, I was also diagnosed with "marijuana abuse". I have not paid this medical bill and I consider the experience insulting and unprofessional.
My sister later developed heart palpitations as well, and when she visited the ER she was also discharged with costochondritis. She also owes a hefty hospital bill now. Neither of us know what is wrong with us and have ~1k of debt to show for it. Neither of us can afford more debt because we look in fear at the debt our mother has yet to pay off.
Without insurance or a health care credit card with high interest rates, you're usually expected to pay up front for health care. When I had these dental emergencies and blood infections, I never had enough money up front for the healthcare due to the circumstances described above, and I was not going to rack up another 1k in the ER just to get antibiotics. So it always ended up being only feasible to source them through both friends (who shouldn't have leftover antibiotics) and actual antibiotic distributors.
I'm not sure what exactly an ER would do. I guess they would write a prescription without worrying about whether the patient would pay for the visit.
(There are requirements for certain types of facilities to provide stabilizing treatment without requiring payment; I simply don't know whether the prescription would be part of that.)
It is probably best for species survival that we keep antibiotics behind a wall. But only if that wall comes down when people need it, not only when they pay the toll.
I'm not advocating that people be able to purchase antibiotics without a prescription -- that would lead to more drug resistance. However, I do think that states should consider allowing pharmacists to do more, such as allowing them to prescribe medications in "simple" cases like this. Pharmacists are the most underutilized medical professionals that we have, and using them more effectively could have a big impact.
For instance, lots of doctors would want to check for an abscess.
(I had a cavity on a tooth and the infection irritated that tooth so I had pretty good pain on that tooth and non localized pain along my whole jaw and also had never had such a painful sinus infection and went to the ER because I didn't understand why it was so painful. I bitched at them, they came back with "the doctor wanted to be sure there was no abscess". What really pisses me off is that having the radiologist do the diagnosis kicked the visit up to a more expensive billing code, because apparently it's complicated to do imaging and defer the diagnosis. They bill you to collect the information to make the diagnosis obvious and then bill you more because they collected more information.)
Doctor's advice is just that - advice.
The point is the doctor wanted to check for an abscess.
I think we're speaking to different things, though. I'm simply saying that there are ways for people without health insurance to obtain a prescription for an antibiotic without going to an emergency room and incurring a large debt.
I'm skeptical that a pharmacist would want to accept any liability to sell the $4 of antibiotics. The not simple part (my relating my experience is to argue that it isn't always simple).
I wonder what the doctor you saw would do with someone less sure of their issue.
You're right of course, but having grown up around people in this sort of situation, I'd like to point out that they view debt differently. It's exceedingly unlikely that a trip to the ER is the thing that destroys their otherwise decent credit, and it's unlikely that the collection agency that ultimately buys the debt will take them to court to collect as they don't have anything to put a lien against and may not even have an income to garnish.
In other words "leave you with crippling debt" isn't nearly as scary to the people in that situation as it is to someone who isn't.