The health insurance industry: perpetuating the opioid crisis through policies of cost-containment and profitability

Abstract

Michael E Schatman1, Lynn R Webster21Foundation for Ethics in Pain Care, Bellevue, WA, USA; 2PRA Health Sciences, Salt Lake City, UT, USA"People don’t trust private health insurance companies for all the right reasons." – Senator Bernie Sanders.Throughout the world, industrialized nations look at the USA and are befuddled by its opioid crisis. Between 1999 and 2011, we witnessed the number of opioid deaths in the USA increase from 4,030 to 16,917,1 with these figures having seemingly stabilized over the past several years.2 Many agree regarding the root causes of the crisis, with an analysis by Webster et al3 identifying health comorbidities (most prominently substance use disorders), payer policies mandating methadone as a first-line treatment option, physician error due to a lack of knowledge, patient nonadherence, unanticipated medical and mental health issues, concomitant utilization of other central nervous system depressants such as benzodiazepines, and sleep-disordered breathing as contributory.