Medical Bartering, by Cynthia J. Koelker, MD

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Medical bartering is as old as the hills, yet still alive today. Though you may not have encountered medical bartering in your own community, a quick web search will reveal that the days of paying your doctor with chickens continue into the 21st century.

Of course, when the grid goes down or our currency collapses, you’ll need to find another method of payment for everything. On the other end, with store shelves empty, medical supplies may become a valuable medium of exchange.

When stocking up on medical items for your family, it’s a great idea to purchase extra, currently inexpensive supplies for others who may want or need them in times of crisis.

Items to consider for bartering include OTC medications and supplies, as well as medical skills. Under current law, bartering for prescription medication is not legal (unless you are a licensed medical professional).

Bartering may occur person-to-person or via an exchange involving a third party. If you have a survival group, a written plan is highly advisable, especially regarding the ethics involved.

For example:

  • Is the single case of formula you have on hand for your grandchild worth only the $20 you paid for it or worth a $500 rifle to the parents of a starving child? Would such a trade be ethical (as it seems to be in today’s medical system)?
  • A nickel’s worth of antihistamine may help your runny nose today, but how much would you pay if your toddler were covered head-to-toe with hives?
  • If a nurse currently receives $15 to administer a $5 bag of IV fluid, will you charge someone the hundreds of dollars a hospital would charge?
  • Or if you ever had a bad case of gout, what would you pay for a dollar’s worth of naproxen?

Having a written policy with room for flexibility and generosity may prevent disagreements at a later date when fear comes into play.

Many over-the-counter drugs are extremely powerful, especially the ones that were by prescription only not many years ago. Here is a short list of OTC drugs potentially useful for future barter:

  1. Tylenol – primarily for pain, but also fever
  2. Anti-inflammatory drugs (ibuprofen, naproxen, aspirin) – for pain, fever, inflammation, sprains, arthritis, gout
  3. Meclizine – for nausea, vomiting, and vertigo; also may help anxiety
  4. Loperamide – for diarrhea
  5. Diphenhydramine – for allergies, hives, itching, and insomnia; also may help anxiety
  6. Non-sedating antihistamines (cetirizine, loratadine) – for allergies, hives, itching
  7. Acid-relievers (ranitidine, omeprazole, lansoprazole) – for heartburn, ulcers/gastritis
  8. Asthmanefrin – for asthma and possibly allergic reactions
  9. Bacitracin – for superficial skin infections and prevention of infection
  10. Hydrocortisone cream – for red, itchy rashes
  11. Antifungal creams (clotrimazole, Lamisil) – for athlete’s foot, ringworm, other fungal diseases
  12. Multi-vitamins– especially useful for prolonged malnutrition

Insulin is more expensive, but certain formulations require no prescription and may save a diabetic’s life. Fish antibiotics are intended for aquarium use but some are the same as human antibiotics.

It is not legal to share a prescription medication, but leftover antibiotics, steroids, and pain pills may be worth their weight in gold if pharmacies are empty. To comply with the law, it may be best to recruit a physician, pharmacist, or dentist for your group who could then prescribe, sell, or dispense any available prescription medication, or act as a professional third party for a bartering transaction.

Other OTC medical supplies are useful barter items including:

  1. Pregnancy tests
  2. Condoms and spermicide
  3. Bandages, Band-Aids, medical tape, gauze
  4. Wound cleaning supplies (soap, Hibiclens, bottled water)
  5. Wound closure strips
  6. Laceration trays
  7. Diabetic testing supplies
  8. Ice packs and hot water bottles
  9. Ace wraps and Coban
  10. Rehydration solution
  11. IV administration kits
  12. Dental repair kit
  13. Oil of clove
  14. Crutches, walkers, wheelchairs
  15. Casting supplies (plaster, stockinette, padding)
  16. Urine test strips
  17. Strep test kits
  18. Reading glasses
  19. Hearing aid batteries
  20. Arm slings

Medical skills are at least as vital as other work (chopping wood, gardening, animal husbandry, defense, et cetera). Whether medical care should be given away without charge should be discussed before the need arises. A balance of paid care and perhaps a tithe of unpaid care is one option. Keep in mind that, in general, what people don’t pay for, they don’t value. Any seasoned medical professional can confirm this is true, and it is often difficult to decide when to “pay it forward”. Loving your neighbor as yourself does not necessarily mean giving everything away (and thus making your own family a burden on society).

Although it’s doubtful you can make a living off medical bartering in times of crisis, having extra medical supplies or skills to exchange may allow you to acquire items you’ve forgotten or could not previously afford, or are running low on (food perhaps). In my Survival Medicine classes I emphasize such skills, to help your own family and community should there be no doctor and you’re truly on your own.

Cynthia J. Koelker, MD

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