Republicans and health insurers are driving up the opioid death rate
If you knew nothing about American politics — and believed that most people tell the truth — you would listen to the dire Republican rhetoric on immigration and think they cared about opioid addicts. Every day, some sententious conservative demands Biden does something to stop the flow of fentanyl from Mexico. Sadly, you would be wrong.
Republicans do not give a damn about drug users. Their warnings on immigration are pure hot air. The proof? They got almost all they wanted in a bipartisan immigration bill. Yet they are likely to vote against it. And they think opioid users should just die. The statistics prove it.
The risk of death from opioid addiction is halved with medication-assisted treatment using buprenorphine, methadone, or naltrexone. That is good news for the 2.5 million Americans living with ‘opioid use disorder’ (a fancy phrase for ‘addict’), But only if they can get it — which is not guaranteed. And for that, you can thank the GOP and the health insurance industry.
Standing between the addict and recovery is a favorite cost-saving tool for health insurers — ‘prior authorization.’ This sadistic mandate requires healthcare providers to seek permission from insurance companies before they prescribe a treatment. And insurance companies have targeted one of these effective addiction fighters. As the Guardian reports:
Prior authorization has targeted buprenorphine in particular. Insurance companies can set qualification criteria that require patients seeking treatment for opioid use disorder to submit to urine drug tests, require pill counts, set dosage limits, and mandate patient education or counseling. It also requires doctors to fill out lengthy forms and wait for approvals. All of which, doctors said, makes patients feel stigmatized and delays treatment during an often narrow window when someone is willing to try addiction treatment.
If you live in a conservative state, your state government is firmly on the side of the insurance companies. This callous disregard for the citizen is typical for the profits-over-people, corporate ass-lickers flying the Republican banner.
As the Guardian further reports,
What’s more, prior authorization requirements are not evenly distributed through the health system. For-profit health plans and Republican-leaning states tend to require prior authorization more frequently, according to recent research by Dr Christina Andrews, an associate professor of health policy at the University of South Carolina. Andrews studies prior authorization and is gathering data about how it affects access to buprenorphine.
“I have a whole team of graduate students that spend hours and hours a week wading through the member handbooks and provider manuals for the Medicaid fee-for-service and managed care plans,” said Andrews. “Their rules and regulations are incredibly arduous and complex.”
In her analysis, Andrews said the use of prior authorization in red states suggests the tactic is shaped more by cost control pressures and partisan concerns about criminal buprenorphine diversion than to science about the medication itself.
For this pro-death philosophy, you can thank propaganda. Pro-profit corporate shills have convinced the average MAGA that any government attempt to reduce health costs is a deep-state, socialist plot. And thus, the US has shit healthcare at nosebleed prices. And healthcare outcomes for residents of red states are worse than for those in blue states.
Judged by results in the rest of the industrial world, (life expectancy for one), government-managed healthcare systems are better than for-profit attempts. The expense in the American system is driven not by medical expenditures but by corporate profits, marketing expenses, executive salaries, executive benefits, and the cost of denying customers reimbursement for their medical expenses.
Medicare does not have to make a profit. It does not have immoderate marketing expenses. HHS cannot turn you down if you are 65. And the Secretary of Health and Human Services, Xavier Becerra, earns $221,400. I am sure that the government wastes money, but it at least aims to maximize the expenditure on healthcare, not non-medical expenses.
The cost of healthcare has left many Americans without, or with insufficient, health insurance. Even though the Affordable Care Act (ACA, aka Obamacare) has made healthcare insurance accessible to millions more Americans, Republican resistance watered down the benefits — no Medicare for all (single payer) or a government option. Politics has even left people with Medicare or Medicaid coverage with large medical debts.
So the next time you hear a Republican bleat that they care about opioid deaths, remember that they lie like they breathe.
Personal note: I have lived in both the US and the UK. In the UK the first question a medical office asks you is “what’s wrong?” In the US, it is “what insurance do you have?”