About That Opioid Epidemic

Credit where credit is due: Medical science and pharmacology have been nothing short of miraculous over the past century. People live longer and healthier lives as a result of breakthroughs in our understanding of how the body works, and how it responds to medications.

But we are also beginning to see some troubling consequences of our reliance on “miracle” drugs. Scientists warn of an emerging resistance to penicillin and other antibiotics, and blame their overuse. And then there is the opioid epidemic, which is yet another example of the problems that emerge when drug use and policy are dictated by the profit motive rather than by medical science and the Hippocratic Oath’s dictum “First, Do No Harm.”

AP and the Center for Public Integrity recently released a study detailing the effects of Big Pharma lobbying on opioid use and abuse. It should give us pause.

Key findings from the reporting:

 Drug companies and allied advocates spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade; by comparison, a handful of groups advocating for opioid limits spent $4 million. The money covered a range of political activities important to the drug industry, including legislation and regulations related to opioids.

The opioid industry and its allies contributed to roughly 7,100 candidates for state-level offices, with the largest amounts going to governors and the lawmakers who control legislative agendas, such as house speakers, senate presidents and health committee chairs.

The drug companies and allied groups have an army of lobbyists averaging 1,350 per year, covering all 50 state capitals.

The opioid lobby’s political spending adds up to more than eight times what the formidable gun lobby recorded for political activities during the same period.

There’s much more.

I know I’m beating a dead horse (what, no medical interventions for the horse?), but there are economic arenas where markets work beautifully, and there are arenas where they don’t. Health care falls in the latter category. “Buying” health care is not equivalent to buying a car or a stove or other consumer good. The parties to the transaction do not possess equivalent information, and the “buyer” needing immediate care is rarely in any shape to go comparison shopping in any event.

The opioid epidemic is just one more example (in a very long list) of what happens when we insist on maintaining markets and encouraging the profit motive in a sector where informational and power asymmetries make genuine competition impossible.

Perhaps–if this election gives us a sane President and legislature–we can begin to correct the situation, by revisiting both the prohibition on government’s ability to negotiate drug prices, and the inclusion of a public option in the Affordable Care Act.

And someday–no doubt after I’m long dead–we might stop letting lobbyists make health policy, get Medicare for All or its equivalent, and join the majority of countries that have recognized that access to health care and lifesaving drugs should not be treated as  profit-generating consumer commodities.

Comments