We have treated the utility industry since the Sherman Antitrust Act was signed into law in 1890.  Until the 1990’s most health insurance companies were mutual companies … the were NOT FOR PROFIT businesses and their policy holders basically owned the company.  but starting in the 1990’s the healthcare insurance industries began “demutalizing” … they converted the companies into FOR PROFIT, PUBLICLY HELD COMPANIES and their focus change to their bottom line profits and price of their stock.   The people who were stockholders became more important to the insurance company and large group health insurance plans than the healthcare that they provided.

In the last decade or so… mergers having been happening and we are being left single companies that provide various services,, that can both self serving and “feed/refer” business from one component to another.

CVS Health is a good example, first in the pharmacy business in 1964 with pharmacy depts in the then Consumer Value Stores. Today, they have some 10,000 community pharmacies,  Minute clinics in their stores, owns the largest long term care pharmacy (Omnicare), one of the largest Prescription Benefit Managers (Caremark), one of the largest Part D insurers (Silver Scripts) and currently trying to close a 60+ billion dollar deal acquiring Aetna insurance with some 43 million beneficiaries.  Their Minute Clinics which were originally suppose to deal with just acute health issues is starting to move into treating chronic health issues.

These health monopolies may or may not be able to “force” a pt to use all their services, but they can put into place financial incentives or disincentives to stay within their system and force pts to contribute to their bottom lines.

All of these insurance companies are exempt from Sherman Antitrust by the McCarran Ferguson Act.. So what is ILLEGAL for other business to do, these insurance companies can do without any concern of violating any law or suffering any consequence from the DOJ.

In the last year, Arkansas, Ohio, WV has caught PBM’s charging excessive costs for prescriptions (multiple millions in each state) they manage the bill paying for state employees and/or Medicaid pts. These are national PBM’s so it may not be long before other states start finding out that they are being “taken to the cleaner” by these PBM’s and taking some corrective action.

Personal experience, Barb had a chronic medication that our Part D/PBM wanted a prior authorization and a $600.00+ copay for her 90 day medication and I was able to find a big box store where I could purchase the same medication/strength/quantity for $44.00 – by PAYING CASH.  Saving abt $2,400.00/yr on JUST ONE PRESCRIPTION.  Maybe this is why they can charge pts about $30/month for premium… 

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What a dramatic difference between those on the stage the first night and the second night… the first night it was like a group of Type B personalities participating in a very “polite debate” The Second night was like a group of type A personalities in a “cat fight”.

They keep talking about “Medicare for all” …but when you listen to the real details that they are tossing out there is really should be called “Medicaid for all” or “VA care for all”… they are talking about no premiums, no deductibles, no copays… and they even want to provider “free healthcare” for illegal aliens.

Do you know what you get when all healthcare becomes “FREE”… you get lines out the door, around the corner and down the street.

They also claimed that “healthcare is a HUMAN RIGHT ”  does this mean that both chronic pain pts and those with various mental health issues – including additive personalities – deserve appropriate care ?

They talked about various discrimination…  Roe v Wade and women’s right, LGBTQ’s discrimination, discrimination with school busing … but discriminating against chronic pain pts and substance abusers… apparently NOT ON THEIR RADAR ?

As many of these 20 contenders start falling off, the remaining will start having meeting in many communities are the primaries start happening. Is this where the chronic pain should start having demonstrations and trying to get discrimination of chronic pain pts on the NATIONAL AGENDA ?

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Audit report raises concerns with effectiveness of prescription drug registry

https://helenair.com/news/state-and-regional/govt-and-politics/audit-report-raises-concerns-with-effectiveness-of-prescription-drug-registry/article_b406cb8f-f2d9-5885-8f5f-92669f47a180.html

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Opioid-related ER visits decline in Massachusetts

https://www.boston25news.com/news/opioid-related-er-visits-decline-in-massachusetts/961737773

BOSTON – A state panel says the number of emergency department visits by people with opioid-related issues dropped by nearly 6 percent in Massachusetts from 2016 to 2017.

The report released Wednesday by the Health Policy Commission is based on a state database of hospital discharges up to 2017, the most recent year available.

The HPC says even though opioid hospitalization rates are down the opioid epidemic is still hitting Massachusetts harder than some other states. And it may be hitting some unintended targets. 

Until recently, professional musician Ellie DeOrsey was able to perform with a Rhode Island Orchestra thanks to the use of oral fentanyl. 

But when she was forced to change doctors because hers moved away, her treatment changed. 

“It didn’t affect my judgment, my thinking, it just took my pain away,” Ellie told Boston 25 News. “And my first office visit with this doctor, his first thing was: I will not prescribe you fentanyl.”

Ellie, like many patients with chronic pain, believes the opioid epidemic is forcing doctors to sometimes turn away from pain-killing drugs that work in favor of ones that won’t draw the attention of the DEA. 

The commission analyzed emergency department visits, and inpatient hospital stays, for people who have an “opioid-related diagnosis,” such as opioid dependence, misuse, or overdose.

Nearly 68,000 opioid-related hospital visits occurred in 2017, a little more than 2 percent of all discharges.

The drop came after years of increases.

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AG: Addiction Treatment, Trafficker Arrests Key To Fighting Wisconsin’s Growing Meth Epidemic

https://www.wpr.org/ag-addiction-treatment-trafficker-arrests-key-fighting-wisconsins-growing-meth-epidemic

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Using Opioids and Having a Job—It’s Not Easy

www.nationalpainreport.com/using-opioids-and-having-a-job-its-not-easy-8840192.html

By Denise Hedley

Those of us with chronic pain are well aware of the new laws that have labeled the opioid crisis and thus punished chronic pain patients. We are all affected in one way or another, and a good number of us have had our medications taken from us. Just today, I was told to take Advil for my pinched nerve and three herniated disks in my back – oh and from now on, I’m supposed to basically live on my heating pad.

Those of us who have lived with chronic pain for quite a while are well aware of what it takes to hold down a job with an invisible illness. Most of us hide it for as long as we are able to work. We are the ones who are not addicts, of course, but there is a new threat to the chronic pain community in the form of proposed legislation and other movements that want to punish those in pain who are still able to work.

The fear of abuse is so rampant, that they want to make pre-employment and random drug screens add opioids to their lists of banned substances for the workplace. In those jobs that have safety concerns this might be understandable that they might worry about impairment. This move, however, seems more like a witch hunt.

What is not understood by many of the parties proposing these actions is that those of us who function only because we have this one tiny tool towards some degree of relief do not find ourselves impaired. We are better able to focus. For some, this relief could be the only thing keeping them in the workforce where they can have a benefits package and better insurance.

It is now recommended that prescription pain killers be considered a violation of the drug-free environment. Employee Assistance Programs (EAP) have now been advised to recommend that any employee who is using prescription painkillers be referred for treatment.

Companies who have thus far avoided drug testing programs may soon be required to begin one. There is a large movement towards taking the war on opioids into the workplace. Companies are now requiring employees to notify their employers if they are placed on prescription painkillers. Most will be required to take leave for the duration of their pain treatment while others may lose their jobs. Ironically, the company does not have the right to ask what those employees are receiving their pain management treatment for.

There have been some moves, as a result of the recent HHS task force activities, to rewrite instructions to primary care physicians as to the prescribing of opioids to those chronic pain patients with a proven history of staying within guidelines. The right to continue treatment seems like it is being excluded for those patients who are still able to work. If all of this new legislation passes, then the war on opioids is taken too far and it seems like it officially becomes a war on chronic pain.

This gives us one more reason why those of us in the chronic pain community need to be more vocal. Even if it is only one person at a time, our voices must somehow be heard.

Denise Hedley

Denise Hedley was initially diagnosed with Fibromyalgia in 2009. Her condition has worsened, and was diagnosed with bilateral RSD in January, 2019. She also suffers from Osteoarthritis, 2 herniated discs, and Systemic Lupus Erythematosis

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The DEA has previously stated that a Pharmacist needs to “resolve” issues that the DEA considered RED FLAGS..  One of their RED FLAGS is a pt that travels long distances to get a controlled  Rxs filled… because that is what substance abusers/diverters do… so – according to DEA logic – anyone who does this must be a substance abusers/diverters.

So according to this pt, apparently some RED FLAGS are IMPOSSIBLE for the Pharmacist to resolve USING COMMON SENSE.  The fact that the pt’s insurance company has LOCKED the pt into this pharmacy – for some reason .. makes no difference to the war on drug mafia.

This may answer my concern about pts paying CASH for part or all of the cost of controlled substances because of QUANTITY LIMITS of their insurance companies or the fact that their insurance will no longer pay for a particular medication. This is another RED FLAG according to the DEA

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https://www.foxnews.com/shows/fox-and-friends

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Colorado’s example shows legal issues marijuana could bring to Illinois

https://wgntv.com/2019/06/25/colorados-example-shows-legal-issues-marijuana-could-bring-to-illinois/

CHICAGO – For all the back-slapping and applause as Illinois Gov. JB Pritzker signs legalized marijuana into law Monday, local law enforcement is bracing for problems that could come along with it.

Legalization doesn’t suddenly remove the drug trade’s criminal element, they say, while some argue it even inspires it.

As one federal agent told WGN Investigates, “Look to Colorado for signs of some of the trouble ahead.”

Just last month, investigators in that state seized more than 80,000 plants and 4,500 pounds of harvested marijuana in the largest marijuana black market investigation in Colorado’s history.

“The legalization of marijuana has created all kind of problems,” said Jason Dunn, U.S. Attorney for the District of Colorado. “These are pure black markets creating large amounts of marijuana for distribution out of state through criminal enterprises.”

In the Denver area, police say criminals have ignored limits designed to constrain production, growing so much black-market marijuana, it’s being illegally shipped in significant amounts to seven states, including Illinois.

There are also concerns about road safety. In Colorado, marijuana-related driving deaths have more than doubled since legalization. There were 139 in 2017, up from 55 in 2013. Marijuana was involved in 21 percercent of the traffic fatalities in 2017.

In Illinois, the governor and others portray the legalization of marijuana as a new revenue stream – plus a new start for people who have a criminal record for relatively minor amounts of pot possession.

Under federal law, marijuana is still considered to be an illegal controlled substance on par with heroin. But agents are more concerned with large-scale sellers, than recreational users who use these products generated out of hemp cbd flower.

As for the impact on the drug trade?

A top official with the DEA in Chicago tells WGN Investigates: “These are trans-national criminal organizations. They’re in it to generate revenue and they’re not going to stop.”

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