When prescribing change to a system, it hurts everyone to attack the people who run that system.
In healthcare, nobody wins when we condemn healthcare providers for doing their job. That statement holds from recommending procedures, to prescribing drugs, and even, or maybe most importantly, making money.
The problems occur when as a patient you aren’t paying the doctor, but you are paying the hospital. Or, you are paying an insurance company. Or you are paying with your time because of onerous government regulations. Then, even as a patient, you are no longer the client, you are the product.
Despite the good people who make the best of it, our system is currently broken.
We have a weird mix of government and private healthcare that allows third parties to come in and arbitrage the market by abusing the rules. And, that has led to one of the most insidious issues facing modern healthcare: doctors have become the villains. So to protect themselves, doctors are forced to waste their time on paperwork instead of patients. They have to validate their actions to insurance companies, they have to defend themselves to government, and if they make a mistake the result could be jailtime.
Best sign that we’re hurting the ones who are suppose to heal us? The epidemic of healthcare workers who commit suicide.
Too many doctors have to practice defensive medicine instead of good medicine in many circumstances. Fortunately, there has been a growing movement of doctors opting out of this mess. They are choosing to practice in a way that they find moral instead of suffering under the ownership of a hospital system or government-reporting system.
These doctors are almost all a part of the growing number of cash practices. They range from concierge primary care doctors, to cash-only doctors, to outpatient surgery centers, and even now some hospitals have started down this path.
However, try as they might to opt-out of the bureaucratic tangle of modern medicine, these doctors still face the issue that government second-guesses their ability to prescribe drugs.
For instance, opioids have increasingly become harder for doctors to prescribe as more action has been taken to clamp down on a growing epidemic. And, given the rhetoric on Capitol Hill, it is likely to get worse as Congress continues to posture on opioids. The solutions have been numerous, but they almost all have one thing in common: they treat the doctor as the criminal.
The great majority of doctors are good actors. These good doctors, which we should consider all doctors until proven otherwise, are treated as if they want to harm their patients. They are being treated as if every drug they prescribe is borderline criminal. The end effect is that many doctors are prescribing drugs that they might not think are as effective as they need to be. And, the true tragedy is that patients that would benefit are having to go without. A 28-year-old bureaucrat without a medical degree shouldn’t be the one deciding if my loved ones can receive a medicine or not.
There are other solutions.
First, the problem needs to be sorted out into different issues. While there are still a lot of problems in the prescribed usage, a lot of recent “opioid” related deaths have been from opioids that come not from Mexican cartels. In fact, two dangerous and inexpensive compounds in particular are rapidly increasing. Both Fentanyl and counterfeit pills (containing heroin and synthetic opioids) are coming over from cartels in large and increasing numbers.
And the growth in these deaths is very alarming. From 2013 to 2016, deaths from Fentanyl increased 520 percent, and these deaths are mainly from drugs obtained illicitly.
To put that into perspective, because percentages can be misleading, Fentanyl-related deaths now outnumber deaths from pharmaceutical opioids, which only increased by 18 percent over the same time period. In other words, we are facing an opioid epidemic, but it is Mexican-cartel driven.
I realize nowadays it’s more popular in many circles to condemn doctors and corporations rather than drug dealers and cartels, but drug cartels are bad, m’kay?
Opioids are short-acting drugs, it is evident that they have a downside, and it is great that the medical community is working on ways to avoid using opioids. However, doctors understand the side effects and down sides of the drugs that they are prescribing. The wrongful actions of a few doctors, a few patients, and the evil actions of cartels shouldn’t come between patients and their medicine.
Charles Sauer (@CharlesSauer) is a contributor to the Washington Examiner’s Beltway Confidential blog. He is president of the Market Institute and previously worked on Capitol Hill, for a governor, and for an academic think tank.
