It’s no secret that this country is in the midst of an opioid epidemic. But here’s something you don’t hear about every day: Insurance companies are one of the main players pushing addictive painkillers.
Why? Because on the whole, those high-risk generics are cheaper than the pain meds that carry a lower risk of dependency.
I don’t know about you, but I laughed out loud — quite literally — at this revelation. Not because it’s funny, mind you. (There’s nothing funny about our country’s current opioid crisis.) But because it so perfectly sums up the laughable levels of dysfunction that plague our healthcare system.
It seems as if, behind every public health crisis that could be stopped with a little regulatory intervention, there’s always a big business that simply won’t allow it to happen. Or in this case, a business that’s complicit in creating the problem.
After all, insurance companies are the gatekeepers to Big Pharma’s stockpile of drugs. Most patients can only afford to take whatever’s covered under their policies. And it’s true — safer alternatives to addictive opioids are more expensive.
But that excuse is a bunch of hogwash, and everyone knows it.
For one thing, drug companies make the drugs — which means that they can charge whatever they please. It’s not as if we’re talking about some pricey new medication here. (Not that new drugs should cost as much as they do, either — but that’s a conversation for another day.)
But even if this defense did hold even an ounce of truth, so what? Why are we giving insurance companies a free pass to value cost control over human lives?
Ultimately, that’s where my beef in this situation really lies. I rarely talk about insurance companies, as I can only fit so many angry rants into one e-letter. But maybe it’s time I started calling them out for the hateful crooks that they are…
The whole healthcare industry has taken heat for the opioid crisis in recent years — drugmakers, doctors, pharmacies, and everyone in between. But somehow, insurance companies have dodged any criticism, despite playing a very big role in feeding our country’s addiction.
Let me give you an example. Nearly 36 million people have a Medicare drug plan. But only a third of those patients have access to buprenorphine — a lower risk painkilling skin patch. Along these same lines, prescriptions for non-addictive lidocaine patches require prior approval. (Unless you want to pay the prohibitively expensive cost out-of-pocket, that is.)
But go fishing for common opioids, and you’ll typically find full-coverage and few pre-authorization requirements. Ironically, it’s less of a hassle to get the drugs than it is to get treatment for the near-inevitable addiction that follows.
Consider the fact that the nation’s biggest insurer has morphine on the “cheap” coverage tier — and no special permissions are required to fill a script. But if you want some Lyrica — a non-opioid drug that’s prescribed for nerve pain — then you better have tried every other pain drug on the planet before you even think about asking your insurance company to pay for it.
And that’s the case with practically all brand-name drugs. (Unless, of course, your insurance company has a deal with the manufacturer. In which case, they’ll pay less for it, while out-of-pocket consumers get hit twice as hard.)
The sad truth is that one in five patients will still be taking opioids a full year after a doctor hands them that first 10-day prescription. And with insurance companies advertising them as “lower cost alternatives” to other pain meds, it’s no wonder why.
This is the kind of gross, irresponsible stupidity big businesses burden our healthcare system with. Between the pre-approvals, the denials, and all the other fiery hoops they make us jump through just to live our lives, they should be on everyone’s hate list — not just mine.
Well, everyone’s except their best buddy, Big Pharma’s. Because in case you haven’t noticed, this is a very convenient arrangement for the drug industry.
Here’s a news flash for you: Big Pharma wants us to be addicted. And the reason why is simple. If we’re addicted, they sell more drugs.
Their strategy couldn’t be more transparent — or effective. If docs want to prescribe something a little less strong that isn’t so addictive, Big Pharma raises the prices on those drugs, and then colludes with the insurance companies to limit access.
And you can’t convince me that there isn’t collusion. Because this is a racket if I ever saw one! One that represents a win-win for big business… and a catastrophic loss for the American people. And what do you think our government is doing about it?