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Who’s going to pay for the Opioid Crisis?

Insurers are loosening policy language to allow more treatment for opioid addiction. Treatment centers and providers are opening, expanding, and increasing services to meet growing demand. Workers’ comp requires treatment for those addicted or dependent on opioids, leading to higher costs for employers, insurers, and taxpayers. Medicaid will be saddled with much of the burden, as addicts often lose their jobs and have no other coverage – so we taxpayers will foot the bill.

We know who’s going to be writing the checks – ultimately you and me and our nations’ employers in the form of higher insurance premiums, higher taxes, and lower earnings for employers.

That’s wrong.  And not just-kinda-sorta-of-that’s-too-bad wrong, but ethically, morally, and maybe even legally wrong.

The purveyors of this poison have made billions by lying, deceiving, and killing our fellow citizens.  By crushing families, destroying towns, bankrupting businesses, ripping apart our social fabric.

And we’re left paying the bill in dollars, deaths, and soul-searing pain.

I have a modest proposal.  Make the pill-pushers pay. 

Congress should pass a bill, and the president should sign it, making the opioid industry pay for its sins. Treatment coverage, a flat amount for each person that died on their poison, and reimbursement for all past costs incurred by individuals, families, taxpayers, and employers.  Bankrupt the industry, take every penny the owners have, and use it to help those they’ve harmed.

Let’s call it the Corporate Opioid Responsibility Payment Service Establishment Act. CORPSE for short

What does this mean for you?

Make the bastards pay. 



10 thoughts on “Who’s going to pay for the Opioid Crisis?”

  1. What about making the physicians responsible? Many prescribe when something less addictive would work just as fine. We could add some type of “fee” on top of their already expensive Medical Malpractice insurance that would help fund this. While anyone can purchase opioids illegally, usually the addiction starts because of a prescription being written.

  2. I see your point Joe. There absolutely has to be some kind of regulations with the doctors and pharmaceutical companies in better regulating opioid use. I 100% agree.

    There also has to be some personal responsibility among those who use opiods. I’m not saying it is easy to get off or stop. But where is that fine line between blaming others and taking personal responsibility?

    Shouldn’t those who produce alcohol pay for the abused and those killed by DUI drivers? What about gun or knife manufactors? Should they be responsible for those killed? Should Pepsi pay for those who drink soda on a regular basis and develop diabetes?

    Once again. I’m not arguing by any means and agree that MD’s need to stop prescribing opiods like its candy but it can be a slippery slope to pin it all on the pharmaceutical companies or the doctors.

    What a game changer to millions of people if an opioid was invented that didn’t lead to addiction. I read an article not to long ago about a company working on that very thing. A drug that blocks the pain but doesn’t give the “high”. That would be amazing! (I need to find that article…)

    In the meantime the whole Medical community needs to step in and work in this problem. Robin Orchard is doing just that. She is the owner of the IMPACT program in Arizona. It is an inpatient detox program that assists injured workers in getting off of ALL narcotics and staying off them for good. It is paid for by the insurance companies. For those IW who chose to go through it…have been very successful and grateful they did it. However it has been offered for many others who refused to go through the program. Its very sad. Assistance is there, help is there, but people need to take personal responsibility and help themselves.

    Thanks Joe for all your knowledge and hard work in providing so many with knowledge on multiple healthcare topics. Your postings are my 5 am news read every morning. ;)

    1. thanks as always for the thoughtful comment Spencer.
      I’d suggest the difference here is the manufacturers KNEW opioids were addictive, yet denied it repeatedly. Moreover, opioids are highly addictive, unlike sweets; opioids are indeed highly dangerous even when used as intended – unlike alcohol, guns and knives.

      Net is the manufacturers knew the dangers, lied about it, and we – you, me, other taxpayers – have to pay for their sins.

      By any measure that is grossly unfair. They broke it, they bought it.

  3. There is a difference in both intention and knowledge that we should consider when discussing the roles of those involved in opioid prescribing. I agree with corporate responsibility to some degree. I also support physician accountability, however, I believe taking a “just culture” approach may be more effective. I’m not proposing we all make a circle and sing Kum ba yah but I am of the opinion there is an opportunity for education and collaborative engagement which can bring us toward more meaningful and valuable care.

  4. Big problem is there’s money to be made in treatment (for both pain and addiction) but not in prevention. I am not aware of a good solution to that problem, which has had particularly disastrous implications when it comes to opioids.

  5. I think that opioid analgesics do have a place in treating short-term pain such as that which accompanies the recovery from some orthopedic surgeries. That said, wouldn’t it be a good idea to require that every prescription for an opioid contain a written plan to wean the patient off of the drug after a pre-defined period of time or perhaps after a certain clinical milestone was met? If an individual is aware up front that his or her opioid will be only used for a discrete time frame or to accomplish a measurable outcome that person may not come to expect a life-long supply of pills. We do need some unified plan to use these drugs responsibly going forward until a better alternative comes along.

  6. Joe – I like your idea. The manufacturers knew the drugs were addictive, and at least mis-led, if not lied to everyone else. They then pushed the drugs like crazy on to all of us.

    I also agree the Docs who prescribe the drugs with less thoughtfulness than may be appropriate also have a responsibility. Lets require them to use the Prescription Drug Monitoring Programs, in their state and document the findings in their notes before being permitted to write an opioid script for any patient. Draconian – some might say so – but I haven’t heard a better idea to actually achieve responsible prescribing.

  7. Every time I have been prescribed an opiate, it has been procedure related. It was a one time prescription of 15-30 pills. No refills. And pills were left unused. If every doctor who ever wrote an opiate prescription ensured it was for acute pain limited to several days post procedure or injury, or documented terminal pain, we would not have a problem. That is what opiates are appropriate for. They are not appropriate for chronic pain. I agree that the drug companies bear large moral responsibility along with drug pushing doctors. We are licensed for a reason and part of that reason is to protect patients and act in their best interests regardless of what they may ask for.

  8. Make the manufacturers money also go to physician education.. I saw this comment in an article from a gentlemen who was trying to wean himself off of opioids after surgery and being on opioids for less that 6 months. None of the 10 doctors who were treating him had any kind of plan for weaning patients off RX and often said to ‘refill the prescription’ because the physical and mental symptoms were so bad. It took him a month of torture to wean himself off!!!!
    “Each physician has a duty to prescribe only those medications that he or she can responsibly manage for the length of a patient’s need, including the treatment of foreseeable side effects”

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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