I can’t count the number of times that members of the community have stated that they have written their member of Congress about the being denied appropriate medical treatment for their pain… only to have the member of Congress to response with a letter with “canned paragraphs” about the opiate addiction crisis that has to be addressed ?
Likewise, can’t count the times that pts have stated that they must submit to certain procedures – especially ESI’s – or they will not be getting any oral opiates and/or discharged from the practice.
It is reported that there are 10 million ESI’s given to pts every year and abt 5% of these ESI’s will cause the pt to contract https://www.practicalpainmanagement.com/pain/spine/arachnoiditis-part-1-clinical-description
Often repeating these ESI’s provide little/no pain relief to the pt… but can possibly produce some long term additional problems for the pt.
While COVID-19 is the CURRENT CRISIS… there is another CRISIS on the horizon that no one is talking about..
No one is talking about all the taxes that various cities, counties, states and the feds have failed to generate because of COVID-19. Nashville, TN has already raised their property tax rates by 34 %.
If more “financial relief” is provided in the next few months… our country will accumulate abt another 10 trillion… on top of the extra 10 trillion the feds spend during the 8 yrs of Obama and the original 10 trillion that our federal debt grew between 1776 and 2008 (Bush 43).
So how does 30 TRILLION national debt effects everyone’s life ?
Could getting that much national debt… be like a earthquake that creates a tsunami – and you live on the coast… and then there are aftershocks – second earthquakes – that are large enough to create a second tsunami – think minimum wage of $15/hr and another after shock so great that it creates another after shock so great that it creates a third tsunami – think healthcare for all – with no premiums, not deductibles and no copays … for anyone person in our country legals and illegals.
If that doesn’t create massive inflation… nothing will… and in turn the Federal Reserve will be forced to INCREASE the national interest rate… meaning that the interest that is due on our national debt will remind you of the launch of the space shuttle … going straight up !
Maybe it is time to talk to Congress about the 10 billion- 30 billion/yr that is being spent on ESI’s… and practitioners that keep providing these procedures that provide no relief to the pt… that is considered providing and charging for medical services/procedures that are not medically necessary… and there are many COUNTRIES that have banned the administration of the class of medication corticosteroids via ESI’s. In the good ole USA… both the FDA and Pfizer have not recommended/discouraged the use of corticosteroids in ESI’s.
It is also illegal https://medtrade.com/news/billing-reimbursement/beneficiary-inducement-statute-two-important-exceptions/ to encourage -give an inducement for – Medicare/Medicaid pts to participate in a service or procedures that has no medical benefit… Thinks of the promise of the prescriber giving the pt a Rx for oral opiates as an inducement to submit to a ESI procedures using corticosteroids. Not to mention the cost of treatment of the adhesive arachnoiditis that some pts will end up with.
The FDA has come out and stated that pharmacy compounded meds should be used in implanted pumps. There is only one opiate that is approved by FDA for use in implanted pumps Infumorph (Morphine) and Medtronics has done stability studies and this medication will maintain at 90% potency for SIX MONTHS in an implanted pump. There has been some small studies that some of the pharmacy compounds opiates will lose up to 50% of their potency within 3 months of being placed into a implanted pump.
If nothing else, these pts are having to have their pumps refilled every 60 to 90 days… instead of six months…that means that Medicare/Medicaid is paying up to 4 MORE TIMES to have their pumps filled because the practitioner uses a pharmacy compounded product. How many of us would buy medication(s) that could possibly lose 0.5% of its potency EVERY DAY ?
The DEA are raiding practitioners’ office that have been prescribing oral opiates to pts and charging the prescriber for Medicare/Medicaid fraud… and other charges .. billing for medication that the DEA has deemed NOT MEDICALLY NECESSARY.
Maybe the community should start a conversation about all the tens of billions of dollars that Medicare/Medicaid for services/procedures that are discouraged and in many cases are not medically necessary.
Should Congress consider pushing the FDA to ban ESI’s using corticosteroids and get Medicare/Medicaid to declare that these procedures are “experimental”… and Medicare/Medicaid do not paid for experimental treatments and whatever Medical/Medicaid does… the rest of the insurance industry usually follows.
The same thing should be done on pharmacy compounded meds for implanted pump and either banned out right or label their use as “experimental”
It really doesn’t matter who ends up being our President for the next four years…. it really doesn’t matter which party is the majority in the Senate/House… the community needs to start this conversation with members of Congress as soon as the next Congress comes to power… So when the “financial tsunami” of the COVID-19 crisis comes ashore…
Maybe as some of these non-profits that some chronic pain groups are creating could petition the FDA, Medicare, Medicaid to change the status of these products. Has nothing to do with treating pain or providing opiates… it is all about tens of billions of dollars that are being spent that are either illegal or done without medical necessity.
Filed under: General Problems
Not just the injections but also forcing us to see a pain management SPECIALIST every month, expensive UDTs, insisting we run the gamut of expensive alternatives, some of which can do more harm than good for many patients, all to perhaps receive medications that, in many states, have to be sent electronically is asinine. They can’t throw all of these expensive barriers at us then complain about the high financial costs of pain patients.
I agree with everything you mentioned Steve..But isnt that the crux of the problem? MONEY? By these pain clinics pushing these injections on patients that for my self never worked ( which I was then accused of being an addict because only pain medicine helped me) its an easy $10-15,000 dollars of quick easy money for these “pushers” Not only has 2020 been an absolute shit fest, All the “magic these P.M. clinics are pushing has left me emotionally drained. I guess that is the “power grabbers” ultimate goal. Get CPP so tired of fighting we either give up or let them shoot up our bodies with useless but harmful medicines