Everyone in America should be able to access the healthcare they need, regardless of their financial situation. No one should have to choose between going without care or going broke because they got sick or suffered an injury. This shouldn’t even be controversial.
After spending the last 15 years working in and around the healthcare industry, I’ve seen it evolve with new technologies and procedures. What I haven’t seen evolve is our delivery model. While the Affordable Care Act was an improvement in many ways, it also failed to truly challenge the Medical-Industrial Complex.
Healthcare costs are out of control. We pay twice as much as most other developed countries for care that is uneven and inaccessible to many of our residents. A recent study found that our child mortality rate ranks dead last when compared with 20 other wealthy OECD countries.
How can we fix the drastic inequalities in our healthcare system? I believe that universal healthcare should be a core public good, and that a single-payer model is the best way to achieve that goal.
Shifting from a profit motive to a public-health motive will make us healthier and save us money down the road. A single-payer system reins in costs, which are currently out of control, by giving us, the buyers, the leverage we need in negotiating costs. Whether it’s the insurance industry, providers themselves, intermediaries like the pharmacy benefit managers, or medical products makers—the profit motive has run rampant. This is what I mean when I say the “Medical-Industrial Complex.”
I know this can be done, and I am not alone. Public support for universal healthcare is growing. A poll conducted in July 2017 by Associated Press-NORC Center for Public Affairs Research found that 62% of Americans want their government to ensure healthcare for all.
We’ve been told time and time again that it just can’t be done—healthcare for all is too radical a proposal to get through Congress, and the American public won’t support it.
So they say.
But with the public on our side, and with the Democrats set to regain the House in November’s election, I believe now is the time for our political leaders to act.
As a candidate in the Third Congressional race to replace retiring Congresswoman Niki Tsongas, I hear a lot of worry and uncertainty about our healthcare system. Costs are going up, coverage is going down, and our seniors aren’t getting the adequate attention they require. Worst of all, the current Republican-controlled Congress, Senate, and Executive could care less. Their interests are right in line with those of the Medical-Industrial Complex.
My 15 years of experience in the healthcare industry—both in the private sector as an entrepreneur and in the public sector as an Executive Director with Veterans Affairs—gives me the experience needed to take on the challenge of improving our healthcare system.
If elected, reining in the Medical Industrial Complex and achieving healthcare coverage for all will be my top priority. The health of our nation relies on it.
There are a lot of impressive people running for this seat. In a ranked choice voting model, we would have the opportunity to vote for more than one of them and ensure that a majority winner would be our nominee in a 13 person field. Patrick Littlefield is one of the candidates that has impressed me. A former UIP town committeeman connected us, and I also got him in touch with some of our campaign workers. I think the executive experience is very interesting and highly relevant to these health care discussions and worth a closer look. The voters in the CD-3 have an embarrassment of riches to choose from.
I guess my curveball for Patrick would be how this executive experience is relevant in a legislative role, and how he intends to be a drum major leader on health care and not just a follower?
The political power of the medical industrial complex is undeniable. But you can easily get in trouble by identifying the profit motive as being the root of all evil. I am not saying you are doing this here… but I have talked to a lot of progressives who are absolutely convinced that the opioid epidemic is caused by doctors and drug companies getting patients hooked on drugs. It shows a fundamental lack of understanding of how drug addiction and pain treatment work. But it is an easy answer and something that we even see from politicans, including those who should know better. (Maura Healey has compared oxycontin to heroin!).
Healthcare access has definitely improved, but I am starting to see public policy creep into the doctor-patient relationship. What we really need is an effective patient advocacy organization.
And they are, in the main, absolutely correct :
Purdue launched OxyContin with a marketing campaign that attempted to counter this attitude and change the prescribing habits of doctors. The company funded research and paid doctors to make the case that concerns about opioid addiction were overblown, and that OxyContin could safely treat an ever-wider range of maladies. Sales representatives marketed OxyContin as a product “to start with and to stay with.” Millions of patients found the drug to be a vital salve for excruciating pain. But many others grew so hooked on it that, between doses, they experienced debilitating withdrawal.
Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids. Many addicts, finding prescription painkillers too expensive or too difficult to obtain, have turned to heroin. According to the American Society of Addiction Medicine, four out of five people who try heroin today started with prescription painkillers. The most recent figures from the Centers for Disease Control and Prevention suggest that a hundred and forty-five Americans now die every day from opioid overdoses.
Heroin and oxycontin are, chemically speaking, cousins: from the poppy, morphine is extracted and from morphine is heroin synthesized; in the other instance, thebaine is extracted from the poppy and from thebaine oxycodone is synthesized. Opium, codeine, oxycodone, heroin and morphine are all ‘opiates.’ The problem of oxycodone addiction, as bad as it is to begin with, is made much much worse by just how easily heroin substitutes into an oxycodone addiction… because they are very similar
I was under the impression that pharmaceutical sales reps all had a science or medical background – the folks who did not get accepted into medical school for example – and their jobs was to help educate the health care providers about their products. I knew they made a lot of money but I never thought of applying for a job as one because I was a good salesman, but lacked a medical or science background.
Then I met two real life pharmaceutical sales reps. One was a kid whose father I used to ski with. “Benny” had a degree in hotel management and hospitality and was a former bartender at TGIF who went on to selling vinyl siding and window replacements but went on to being a sales specialist for the psychiatric drug division of a major company. Along with his company car and five figure expense account, Benny pulls down over $150K a year.
The other guy was the father of one of my son’s friends. “Joe” was a sales manager for a big pharmaceutical company, pulling down $250K a year. He had a business degree and most of his sales experience was selling copier and fax machines.
Heroin and oxycodone both activate the same receptors, and will cause physical dependence in 100% of the people who use them routinely. But the similarities end there. The “war on drugs” view (and what I was taught in grade school) is that getting physically dependent on a drug will automatically make you an addict, but this is not at all true (which explains why the actual addiction rate among those treated for pain is a tiny fraction of one percent and not 100%).
The method of delivery is also crucial here. Heroin is typically injected or snorted, which makes the drug take effect within several seconds or minutes. This increases the euphoric effect, which is of course the point. OxyContin was specifically designed as a slow-release version of oxycodone, slowly releasing it into your body over 12 hours. To defeat this mechanism, addicts need to remove the protective coating. (My understanding is that smoking the pill off a piece of tin foil is a favorite method of both defeating the coating and getting high..) The fentanyl patch is another delivery method designed to slow release of the drug over many hours. This increases therapeutic potential and reduces the likelihood of addiction. The street fentanyl that people are dying from is not being taken as a patch (a point often omitted from news stories).
Also, as someone who has used this medication for debilitating pain, I can tell you that there is truly nothing “feel good” about it. My day is somewhat less miserable and I am able be a somewhat more productive member of society (with bouts of severe pain, I can not hold down a job, although I try to volunteer and be there for my family). My only priority is living a somewhat more normal life, which means I never want to feel “drugged,” much less high. But at this point, I would never tell anyone that I have taken this medication, because of the false belief that the therapeutic use of opioids causes addiction (or that they are even the same thing).
Saying that OxyContin and heroin are the same shows a lack of understanding of how drug addiction and pain control work. Addicts are, at the very least, taking far more medication than their doctor has prescribed. For this reason, they quickly run out and turn to street sources (which is often what kills them).
For those inclined to addiction, I would avoid opioids at all cost. Special care should also be taken with young adults, whose proclivity for addiction may not be known. But I can tell you a story of a 65 year old woman, with a long history of safely using her medication, having her doctor end treatment because “well, haven’t you seen the news.” (This has nothing to do with her medical care — her risk of addiction, is basically zero. It has everything to do with doctors responding to political pressure..) I recently heard a Boston Oncologist on local radio saying that there have been shortages of crucial opioid medications — I have experienced the same thing, and I suspect that these are artificial shortages, caused by companies that want to lower production, to decrease the likelihood of being accused of profiting from addiction.
If you don’t want to take opioids, that’s entirely your choice. But for those of us with debilitating pain, the healthcare system is making it increasingly difficult to follow our doctors’ prescribed care.. The last time I was prescribed opioid medication, MA Health would not cover it, without all sorts of extra-legal requirements. A family member offered to help me out with the cost, only for me to be told that paying myself would cause me to permanently lose my MA Health benefits (my CVS said it already happened to a patient). Think about that… our state is refusing all healthcare coverage for someone who is very sick and exercising a constitutional right to follow his or her doctor’s prescribed care. (And if the worse case scenario is true, wouldn’t an addict presumably need health care coverage?)
I respect the good intentions of everyone here. No one wants to see the opioid crisis continue. But when you start messing with other people’s healthcare, which you know nothing about, you are crossing a red line that has real consequences for real people.
And BTW, I am fine with ending for-profit medical care. My priority is empowering patients and their doctors.’ Once you start compromising that, even if it is for the sake of people’s health and wellbeing, you are opening the door to losing key parts of your healthcare.
Remember, there are conservatives who are absolutely convinced that birth control and abortion are harmful to women — the fact that there are cases where this may be true is not justification for compromising women’s right to decide for themselves.
You didn’t read the article. That statement you just made sums up concisely the problem: Purdue pharmaceutical created oxycontin to ‘mess with other peoples healthcare’ with ‘real consequences for real people’. They absolutely flooded the market with a product that was definitively prone to abuse with false claims that it possessed a definitive immunity to abuse. And they absolutely made a full-court press against the medical communities long-standing distrust of opioids for all but the most serious cases.
And your views regarding both addiction and physical dependence as well as your views regarding the actual medical communities view of addiction and physical dependence are naive. Addiction is a much more complex dynamic than you allow.
As I point out, OxyContin has lower abuse potential than regular oxycodone. (It is slower-acting, decreasing the likelihood of addiction, and the abuse potential for those already addicted) It would be wrong to say there is no abuse potential (as I point out, people actually melt and smoke the pills). So doctors do need to screen out people with a history of substance abuse. The best research we have shows that only a tiny fraction of one percent get addicted to opioids, even after longterm use. With better screening, we can get that close to zero (of course, there is only so much you can do with addicts who are lying to their doctors — addiction is a behavioral health issue, after all).
As for “Flooding the market,” this is just a reflection of better access to medical care, including chronic pain treatment. But we now have companies creating artificial shortages, because they don’t want to be accused of “flooding the market.” Well great, now there are some very sick people going without medication.
The medical system is actually really good at preventing diversion of opioids. Think about it: street heroin (a completely illegal product) is far cheaper than black market oxycontin (a commonly prescribed medicine). That’s pretty impressive. The only way to lower opioid availability further is to create artificial barriers to treatment and to discourage doctors from providing care. This is exactly what is happening, with law enforcement and progressive politicians leading the way.
You are right about one thing — addiction is very complex, far more than we can account for in a BMG comments section.. But the progressive narrative of addiction (that the profit motive is causing drug companies and doctors to get people hooked on drugs) is totally wrong, with serious consequences for people suffering from chronic illness.
BTW, I am all for preventing and punishing false advertising claims. But what I am responding to is limiting access to medication for those who really need it. Let’s not punish patients for the mistakes of big pharma.
Wow, you are grossly uninformed about many things related to the epidemic and you’re using discredited “research” or no research at all to make false and misleading claims.
In your various comments, you twice claimed, “The best research we have shows that only a tiny fraction of one percent get addicted to opioids, even after longterm use.” Would you care to provide a link to that “study”, err letter to the editor?
You also claim OxyContin has lower abuse potential than regular oxycodone. THAT is certainly what Purdue Pharma, the maker or OxyContin CLAIMED, but it is also what they eventually pled guilty in Federal Court and admitted the claim was an unsubstantiated LIE…unless you have a link to some “study” that claims otherwise.
Also given the fact that 2 small pharmacies in a 3,000 person community sold nearly 21 MILLION opioid painkillers, representative of the hundreds of “pill mills” that existed in the US, your claim that “The medical system is actually really good at preventing diversion of opioids.” is laughable. (Or do you feel these pill mills are an example of “flooding the market” and is “a reflection of better access to medical care, including chronic pain treatment”? as you write above)
{Link to story of 2 pharmacies: https://www.npr.org/sections/thetwo-way/2018/01/30/581930051/drug-distributors-shipped-20-8-million-painkillers-to-west-virginia-town-of-3-00%5D
Then you mock AG Healy who for comparing oxycontin to heroin, yet the many doctors and pharmacists I’ve spoken to absolutely say they are chemical cousins and the comparison is very appropriate. All opioids are opioids.
Also, the evidence is in and it indicates that opioids are not effective treatments for long term chronic pain. I hope you can find effective treatment for your pain. But research indicates that opioids are not the solution.