How often these days do we punish those who live responsible and functional lives in order to protect people who don’t?
Now, with the opioid epidemic–no question, a real problem–some are advocating actions that would lead to more pain for patients with legitimate need for such medicines in order to protect those who become addicted.
A New York Times editorial today epitomizes such thinking.
First, to save people who could become addicted, the editorial advocates forcing insurance companies to cover “alternative” approaches to palliation, the efficacy of which some, such as acupuncture, are scientifically controversial. From the editorial:
But doctors have many more options for treating back pain, migraines and pain related to surgery — physical therapy, antiinflammatory drugs, acupuncture, exercise and so on. Some doctors overlook these alternatives because opioids are easy to prescribe or because patients demand them.
One fix here seems obvious: Federal and state lawmakers can require insurers to cover these services, a cheaper option over the long term than addiction treatment. And they should also find ways to expand access to health services by subsidizing doctors, therapists and other health care workers to make periodic visits to remote areas.
Good grief, we will never control healthcare costs if acupuncture and the like are required by regulatory fiat to be paid by insurance companies.
More concerning is that people with real need will be forced into greater inconvenience and under-treatment to protect those who abuse legitimate medicine:
Even when opioids are necessary, doctors can minimize the risk of addiction by taking a few precautions. They can write prescriptions for low doses and relatively short time periods. They should pay attention to monitoring programs that most states have set up to make sure a person is not getting multiple prescriptions from different doctors. And doctors can steer to treatment patients who are obviously addicted.
Doctors are not the only ones responsible for the opioid epidemic, but as Dr. Murthy makes clear, they’ll have to play a leading role in the fight against it.
But given the time pressure and bureaucratic distractions that afflict medical practice today, how often will this devolve into a one small size fits all? If that happens, those in legitimate need of palliation will be forced to experience more pain to protect those who abuse these drugs from themselves.
Not coincidentally, the Times supports legalizing assisted suicide. I can’t think of a better way to make suicide more attractive then making palliating medicine more difficult for suffering patients to access.