New Bill to Lessen the Pain of the Dysfunctional U.S. Healthcare System is a Reminder of Its Critical Flaws

Massachusetts Senator Elizabeth Warren has introduced a bill that attempts to “curb pain” emanating from the corrupted for-profit healthcare system of the United States. Among other things, the bill’s provisions would implement helpful but admittedly inadequate measures, such as making it illegal for insurance companies to revoke a patient’s plan during their course of treatment. There could of course be many reminders about the more critical flaws of U.S. healthcare made in relation to this.

For one, the U.S. spends about twice as much on healthcare compared to other wealthy countries such as Canada, Britain, and Germany. If that spending — which is annually $3.4 trillion ( about 18 percent of annual U.S. GDP) — was reduced by around half, it would be an enormous savings that (all else unchanged) would actually have the U.S. running substantial budget surpluses.

That isn’t to say that budget surpluses are necessarily good (budget deficits can be helpful and natural), but it’s to point out that subtracting the almost $700 billion ($5550 per U.S. household) in budget deficit totals that the U.S. ran in fiscal year 2017 from a $1.7 trillion in healthcare savings would still be about a trillion dollars of budget surplus. It’s strange how rarely this simple point enters the mainstream press, what with the irrational and even harmful attention corporate media such as the Washington Post has given to budget deficits. More importantly though, it’s over a trillion dollars that could be spent productively elsewhere in the economy instead of harmfully allowing health insurance corporations receive it.

Interestingly enough, Berkshire Hathaway, Amazon, and JP Morgan Chase announced plans earlier this year to jointly form a healthcare company for their employees that’s “intended to be free from profit-making incentives.” This is another revealing insight into why a for-profit healthcare system is too flawed to function well — building a healthcare system around corporate profits simply raises the costs too much. The executives at those three corporations aren’t the only parts of the business community to understand this as they seek to reduce their own expenses.

Businessman Warren Buffett has even admitted that single-payer is “probably the best” healthcare system for the U.S. He has made a comparison between U.S. healthcare in 1960 and in 2017 — in 1960, U.S. healthcare spending was only five percent of annual GDP, and almost 60 years later there’s been almost a four fold GDP-based increase in healthcare spending. This reveals again that the amount of resources being devoted to the overall mediocre U.S. healthcare system is excessive.

The for-profit element of the system has other consequences outside of direct economic costs though. One of them is unnecessarily lost lives, with strong evidence finding that over 20,000 people die a year in the U.S. due to being unable to afford health insurance. It is simply a major moral disgrace that world history’s wealthiest country suffers from such a problem.

Also disgraceful is the staggering number of medical bankruptcies per year in the United States. The amount of those per year has been estimated at hundreds of thousands in the U.S. alone (far more than other wealthy countries) and medical bills have been a leading cause of Americans filing for bankruptcy for years. All other OECD countries besides Mexico have universal healthcare and have a much more efficient healthcare system to prevent many of those problems to begin with.

For a practical example, Medicare (a predominantly single-payer healthcare service run by the government) has administrative overhead costs of about 1 to 2 percent, which is usefully contrasted to the 12 to 20 percent overhead costs typically run by the for-profit health insurance industry. This is because inefficiently having thousands of different healthcare payer plans necessitates higher bureaucratic costs with too much paperwork.

And another notable part of the high U.S. health costs is due to the ridiculous prices of prescription drugs there. In 2017, the U.S. spent $450 billion (2.4 percent of GDP) on prescription drugs, an amount that could almost certainly be reduced by about $370 billion ($2930 per U.S. household) by having prescription drugs sold without patent monopolies and other unjust protectionist measures. In a time when at least nearly one in five Americans are unable to afford their medications adequately, this proposal for savings should be considered much more.

It should also be noted what happens an extreme amount of undeserved resources are diverted to harmful corporations such as the pharmaceutical ones. Pharmaceutical companies — such as Purdue Pharma — have used their excess profits to manufacture an opioid crisis (to seek even more profits) through flooding economically downtrodden communities with highly addictive opioids. This has resulted in opioids becoming the leading cause of death for Americans under 50, and it’s also largely been what’s resulted in a decline in the average U.S. life expectancy rate, a phenomenon that’s probably otherwise unheard of in other wealthy nations in the 21st century.

In all, the U.S. healthcare system suffers from significant problems that will require more than tweaking around the edges to solve. Its system requires a major alteration, and the sooner that happens, the less health-based suffering among its people there can be.

Giving Big Pharma Public Hearings, Inspired by the Big Tobacco Hearings

The U.S. Congress – in its decay over the last four decades after being further corrupted by big business interests – rarely has held public hearings in the last several years. It should hold many more public hearings, however, and it should do so on the most important issues facing society today.

Senator Sanders though provides yet another example of why he’s justifiably the most popular U.S. politician, as he continues to focus on the real problems (healthcare, wages, the opioid crisis, etc.) instead of on the regressively McCarthyist and largely nonsensical Russia drama that drains too much news focus. The proposal he has about making the pharmaceutical corporations pay to reimburse the communities they ruined is also clear-sighted and sensible.

Sen. Bernie Sanders (I-Vt.) called Monday for the Senate to hold pharmaceutical companies accountable for any role they’ve played in fueling the opioid epidemic that has spread despair in his state and across the U.S.

In a letter to Sen. Lamar Alexander (R-Tenn.), the chairman of the committee on health, education, labor and pensions, Sanders encouraged him to hold hearings on the matter just as the Senate had once compelled Big Tobacco executives to testify about the deadly hazards of smoking.

“That committee had the courage to demand that the leading executives of the tobacco industry tell the American people what they knew and when they knew that tobacco was addictive … and had killed millions of people,” Sanders wrote. “Though all denied under oath believing tobacco was addictive, we now know they were lying. But the hearing eventually led to real change,” with the Food and Drug Administration regulating tobacco and the rate of smoking in the U.S. at a record low.

Sanders pointed out that the hearing helped states reach massive settlements with the tobacco industry. Several local jurisdictions have already filed lawsuits against painkiller manufacturers. Some have already received settlements. The opioid crisis, Sanders, wrote, “did not happen in a vacuum.” He praised investigative journalists for exposing Big Pharma’s lies about opioid painkillers not being addictive and how small-town pharmacies were flooded with opioids.

“Yet, while some of these companies have made billions each year in profits, not one of them has been held fully accountable for its role in this crisis,” Sanders wrote. “Individual states have received small settlements from companies after taking legal action, but not nearly enough to pay for the costs associated with the opioid epidemic. The states cannot do it alone.”

Sanders sees an economic cost as well as a human cost to the epidemic. And he wants the industry to be liable for the economic costs. Sanders noted in his letter that he plans to introduce legislation that would in part require companies to reimburse communities for the devastating economic consequences that their painkillers have caused.

Opioid Crisis Killing More People Than Breast Cancer

The opioid crisis is largely a result of greedy, profit-driven pharmaceutical corporations such as Purdue Pharma mass producing highly addictive opioids and then flooding economically weak (and thus despairing) communities with them. The problem must be attacked at the root — significantly alter the function of the pharmaceutical industry and fix much of the economic weakness that it thrives on. If neither of those solutions are applied, the problem will keep becoming worse, with all the innocent lives lost that go with it.

More than 63,600 lives were lost to drug overdose in 2016, the most lethal year yet of the drug overdose epidemic, according to a new report from the National Center for Health Statistics, part of the US Centers for Disease Control and Prevention.

Most of those deaths involved opioids, a family of painkillers including illicit heroin and fentanyl as well as legally prescribed medications such as oxycodone and hydrocodone. In 2016 alone, 42,249 US drug fatalities — 66% of the total — involved opioids, the report says. That’s over a thousand more than the 41,070 Americans who die from breast cancer every year.

Much of the increase was driven by the rise in illicit synthetic opioids like fentanyl and tramadol. The rate of deadly overdoses from synthetic opioids other than methadone has skyrocketed an average of 88% each year since 2013; it more than doubled in 2016 to 19,413, from 9,580 in 2015.

Heroin also continues to be a problem, the report says. Since 2014, the rate of heroin overdose deaths has jumped an average of 19% each year.

The opioid crisis has raised significant awareness of prescription painkillers. Between 1999 and 2009, the rate of overdoses from such drugs rose 13% annually, but the increase has since slowed to 3% per year.

In 2009, prescription narcotics were involved in 26% of all fatal drug overdoses, while heroin was involved in 9% and synthetics were involved in just 8%. By comparison, in 2016, prescription drugs were involved in 23% of all deadly overdoses. But heroin is now implicated in about a quarter of all drug fatalities, and synthetic opioids play a role in nearly a third.

These increases have contributed to a shortening of the US life expectancy for a second year in a row.

The states with the highest rates of overdose in 2016 were West Virginia, Ohio and New Hampshire, the report said. The rate of overdose in West Virginia was over 2.5 times the national average of 19.8 overdose deaths for every 100,000 people.

While the outlook nationwide is fairly bleak, it’s particularly bad in some states. Twenty-two states and the District of Columbia had overdose rates significantly higher than the national average.

While overdose rates increased in all age groups, rises were most significant in those between the ages of 25 and 54.

Provisional data for 2017 from the CDC show no signs of the epidemic abating, with an estimate of more than 66,000 overdose deaths for the year. “Based on what we’re seeing, it doesn’t look like it’s getting any better,” said Bob Anderson, chief of the mortality statistics branch at the National Center for Health Statistics.

[…]

According to the 2016 Surgeon General’s Report on Alcohol, Drugs, and Health, 30% of Americans do not seek any sort of addiction treatment because they do not have insurance and cannot afford treatment.

The opioid epidemic is of course worst in West Virginia because of how economically ravaged the state has been by decades of neoliberalism, the increase in deaths being worst among those 25 to 54 notably follows the ages that are regularly considered to be those of prime age workers, and the lack of a national single-payer healthcare system shows itself as a flaw yet again.

Feature on the Opioid Crisis

The Empire Files program did a feature on the opioid crisis that focuses on the behavior of criminogenic pharmaceutical corporations. It is particularly notable for noting that big pharmaceutical corporations have targeted and still do target economically ravaged places suffering from significant despair.

Economic despair is at the core of the opioid epidemic. A lot of those people addicted to opioids would have done much better if they had meaningful work to occupy their time and give them a sense of purpose. Unfortunately though, in many sectors the economic system is so dysfunctional that it fails to provide even basic elements of meaningful community work for people.

There’s a disturbing graph that shows utilization of capacity, and it reveals that there are many, many billions of dollars being lost due to capacity such as buildings not being used. It isn’t because there’s a lack of needed work — on the contrary, looking around plenty of places will have a reasonable person saying that there’s a lot that needs to be done. So there’s a lot of work that needs to be done and a lot of capacity (23 percent in the graph) pointlessly sitting idle, and there’s an economic system that isn’t putting them together for productive benefits.

Screenshot-2017-12-5 Capacity Utilization Total Industry

The U.S. government could enact a massive infrastructure project that would create millions of jobs and/or it could provide low interest loans to support worker cooperatives in economically downtrodden communities. There are other solutions too, and they also need significant will to be applied. The point to make here though is that the situation doesn’t have to be that bleak for the communities, and there’s actually a clear enough method to reconstruct what has been mismanaged.

Opioid Epidemic Cost Revised to a Staggering $504 Billion Annually

The roots of the crisis are found in the criminogenic pharmaceutical corporations and the dysfunctional U.S. economic system. More Americans die every year (about 60,000) as a result of the opioid crisis than the number who died in the Vietnam War. With $500 billion in annual costs, it also means that two years of the opioid crisis will roughly equal the direct costs of fighting the Vietnam War.

The opioid epidemic sweeping the U.S. is far costlier than once thought, with the economic impact of the crisis exceeding half a trillion dollars, according to a new report by White House economists.

The epidemic cost the American economy $504 billion in 2015, which was the equivalent of 2.8 percent of gross domestic product that year, according to the report by the Council of Economic Advisers, or CEA. The White House’s figures are more than six times larger than a previous study because it incorporates the value of lives lost to the epidemic.

The findings come less than a month after the Trump administration declared widespread opioid abuse a public health emergency while stopping short of freeing up federal disaster funds to tackle the problem.

A study released last year estimated the cost of the opioid crisis in 2013 at $79.9 billion, adjusted to 2015 dollars. The White House economists said prior research (see table) didn’t capture the full impact because it at times only measured health-care expenditures or earnings lost from those who die — which overlooks “other valuable activities in life besides work.”

The CEA also said it made adjustments to more accurately measure the number of opioid-related deaths, which often go underreported, and focused on illicit opioids as well as prescription drugs.

“This is the first but not the last publication CEA plans to issue on the opioid crisis,” according to the report. “A better understanding of the economic causes contributing to the crisis is crucial for evaluating the success of various interventions to combat it.”

A Week’s Local Reporting in the Opioid Crisis

A week’s focus of reporting on the opioid epidemic from Cincinatti, Ohio.

The Enquirer sent more than 60 reporters, photographers and videographers into their communities to chronicle an ordinary week in this extraordinary time.

It’s a little after sunrise on the first day of another week, and Cincinnati is waking up again with a heroin problem. So is Covington. And Middletown. And Norwood. And Hamilton. And West Chester Township. And countless other cities and towns across Ohio and Kentucky.

This particular week, July 10 through 16, will turn out to be unexceptional by the dreary standards of what has become the region’s greatest health crisis.

heroin-grid-top -

This is normal now, a week like any other. But a terrible week is no less terrible because it is typical. When heroin and synthetic opiates kill one American every 16 minutes, there is little comfort in the routine.

[…]

Ali walks along McMicken Avenue in Over-the-Rhine, looking for someone willing to pay her for sex.

It’s what she does to get money to buy fentanyl, and to keep a roof over her head. She’s 25 and addicted to the synthetic opiate. She used to take heroin, but now she prefers the more powerful and more dangerous synthetic.

She’s having trouble finding someone to pick her up on this steamy afternoon.

Ali already has changed her dress today. She’s wearing a metallic-studded, purple mini dress. She knows that sometimes her customers want someone pretty. Other times, it doesn’t seem to matter.

Tall and fine-boned, Ali could be a model. But she is emaciated. She has bruises on her neck from shooting up.

She runs a hand through her long, thick hair, grasps it and lifts it from her shoulders before letting it fall back down. Then she does it again. She’s getting anxious. Withdrawal symptoms are starting to set in and Ali thinks she might vomit on the sidewalk if she doesn’t get a fix.

Ali darts across the street, vanishes for a few minutes and returns with her drug in hand. She hides behind a couple of trash cans and uses it.

About 15 minutes later, she’s back, feeling better, walking the street in the hot summer sun.

[…]

Kim Hill searches through the boxes filled with her son’s belongings, unsure what she’s looking for. There’s a box for Tommy’s clothes, sneakers and hats. There’s a box for his cologne.

She can smell him on the clothes he’ll never wear again, and on the green comforter from the bed he’ll never return home to sleep in.

Kim decides to take the comforter home with her.

She will hold it close tonight, in her own bed, while she tries again to sleep. And she will think, “This is what is left of my child.”

[…]

It’s almost midnight on the last day of another week, and the heroin epidemic has done its damage.

18: Deaths known or suspected to be the result of overdoses.

180: Overdoses reported to hospitals in the region. This figure underestimates the actual number of overdoses because it only includes those requiring hospital treatment.

210: Inmates in the Hamilton County Justice Center, the region’s largest jail, who admitted to using heroin or other opioids. Jail officials have estimated that as many as half of all inmates, about 870 this week, have an opioid problem.

$95,550: Cost to taxpayers to house those 210 inmates for one week. If the inmate total is closer to the estimated 870, the cost would be $395,850.

15: Babies born with health problems because their mothers used heroin or other opioids.

34: Investigations opened in southwest Ohio into the well-being of a child whose parent or guardian was known or suspected of using heroin or other opioids.

102 hours, 42 minutes: Time it took first responders to tend to overdose patients. This figure is considered low by dispatch supervisors because many overdose runs are not initially called in as such.