If statistics are to be believed, America is in the grip of a serious drug addiction problem — and a well-intended but misguided part of the Affordable Care Act may be partly to blame.
A story this week on Time magazine’s website quotes medical experts who are critical of an Obamacare initiative meant to reward hospitals that provide quality patient care. The government allocates $1.5 billion in Medicare payments to hospitals based on criteria that include patient satisfaction surveys.
Among the questions: “How often was your pain well controlled?” And “How often did the hospital staff do everything they could to help you with your pain?” That, say critics, is a recipe for patients hooked on legal drugs like OxyContin to demand more medication than they require to feed their addiction.
It’s easy to see how medical staffs can justify overmedicating such patients. Too many negative responses on patient surveys may mean less Medicare reimbursement money, which affects the financial health of the hospital. Far better, then, to give someone the Oxy they demand rather than risk a few layoffs.
In a 2014 survey of doctors, 48 percent of them acknowledged prescribing “inappropriate narcotic pain medication” because of patient-satisfaction surveys. One doctor quoted in the survey said some patients are well aware of how they can manipulate the medical staff to get extra medicine.
Time doesn’t estimate what percentage of drug addiction cases involve hospital patients. Common sense says it would be a fairly small figure, since Americans aren’t waiting till they’re in a medical facility to seek these strong painkillers.
OxyContin and its prescription cousins are opioids — from the same drug family as heroin, which remains illegal and is becoming more widely used in recent years. Perhaps heroin’s resurgence is another unintended consequence of the crackdown on methamphetamines. At any rate, these prescription medications are easily abused, and other statistics are more definite about that problem.
According to the Centers for Disease Control, fatal overdoses involving prescription opioids have quadrupled since 1999. In 2014, a record
47,000 Americans died of a drug overdose, and more than 28,000 of those involved an opioid. It’s no surprise that a few weeks ago, President Obama said the country’s prescription drug problem is as great a threat as terrorism. Drug deaths are rarely as sensational as a terrorist attack, but drugs are certainly responsible for a lot more fatalities.
Time reports there is bipartisan support in Congress to remove questions about patient pain-management from hospital reimbursement rates. That is a common-sense reform that should become law.
The heavier lifting on this drug addiction — severe limits on opioid prescriptions, if not a consideration of an outright ban on their manufacture — still awaits.
Jack Ryan, Enterprise-Journal
