The world is sometimes a very strange place. When you wake up every morning and look out your window, it may all look in apple-pie order. But, secretly, weird stuff has been happening just out of your line of sight. Up in Washington, our representatives have been arguing about healthcare reform. When a bipartisan approach failed, the Democrats decided to push the bill through the system. The arrival of the bill in the Senate provoked the GOP into producing a number of amendments. This was a procedural device. If any changes to the Democrat’s package had been approved, it would have forced the law back to the House. Surprisingly, because trying to get any group of politicians to act together is like trying to herd cats, the Democrats all managed to vote together. That condemned all the amendments to the waste bin of history. One of these had been offered by Sen. Tom Coburn. He wanted a specific provision adding to the law to prevent sex offenders from getting erectile dysfunction drugs through the newly reformed insurance markets. The spirit of the argument was: if you Democrats vote down this amendment, you’ll be giving wake-up drugs to rapists and child molesters at the taxpayers’ expense. Sen. Max Baucus called this a crass stunt.

Now let’s briefly travel back to 2005. The news then reported some eight-hundred sex offenders were getting erectile dysfunction drugs through Medicaid. This caused some surprise, so the Centers for Medicare and Medicaid Services instructed states not to pay for these drugs. Obviously, once released from prison, all offenders are entitled to buy health insurance and, if they require treatment for a genuine problem, the insurance pays out. This will include the possibility of erectile dysfunction drugs. So just what will happen under the reform bill now signed into law and does it matter?

It seems the Congressional Research Service has now written to Sen. Tom Coburn confirming his "worst fears". If any offender is entitled to a subsidy to get health coverage, there are no provisions in the new law to limit the type of drugs that can be prescribed. The law represents the principle of equal treatment for all. Those who are genuinely in need shall receive treatments. So should we care?

Anyone going through a doctor for a prescription should be entitled to treatment unless there’s a good public policy reason to prevent it. As it stands, any convicted offender can use his or her own money to buy any drugs online without a prescription. What extra value would be gained if doctors were told not to write prescriptions for viagra when registered sex offenders asked for it? It’s hard to think of any benefit. If offenders have the money, they can buy viagra online anyway. Denying them treatment through a doctor seems strange. In any event, are all doctors given access to the names and addresses currently used by all the registered sex offenders in their state? Should they routinely search the database every time they are asked for viagra? If the erectile dysfunction is being caused as a side effect of other drugs taken to control depression, should doctors be forbidden to change the dosage of those drugs? Or to refuse any other treatment that might relieve the erectile dysfunction? Picking on erectile dysfunction drugs without explaining how the limitation would benefit the public really does seem like a stunt. If there are good policy justifications, let’s hear them.