In a recent article in Time, Senior Writer Sean Gregory shared a troubling story about Obamacare…
An emergency room physician, Dr. Bill Sullivan, recently saw a patient who complained of abdominal pain. Before Dr. Sullivan could provide a diagnosis, the patient specifically requested Dilaudid — a potentially habit-forming painkiller.
Dr. Sullivan noticed that the patient had a long history of using opioid prescriptions, so he suggested a less potent option than what the man requested. But the patient rejected the doctor's suggestion, stating, "Morphine is sh-t." Still, Dr. Sullivan declined to prescribe Dilaudid. Of course, Dr. Sullivan made a judgment call about what was best for his patient's long-term interest.
But his decision may have made waves with his employer…
Refusal to prescribe the powerful drug could cost his hospital major money due to a specific reform in the Affordable Care Act.
You see, an Obamacare initiative was created to reward hospitals that provide patients with quality care. The Centers for Medicare and Medicaid Services (CMS) is allocating nearly $1.5 billion in Medicare payments to hospitals on specific criteria that include patient satisfaction scores.
Two of the questions include:
- "During the hospital stay, how often did the hospital staff do everything they could to help you with your pain?"
- "How often was your pain well controlled?"
While the intent was to hold hospitals to higher standards, this particular Obamacare policy backfired…
How Obamacare Is Creating Painkiller Addiction
The ACA created a monetary incentive for hospitals to get glowing reviews from patients.
And that's where the new policy went down a dark path…
It ultimately led to what amounts to prescription drug abuse – doctors hawking feel-good drugs in order to secure better patient experience reviews.
The Journal of Patient Preference and Adherence published a survey in 2014 that found 48% of doctors admitted to prescribing inappropriate narcotic pain medication because of patient satisfaction questions. According to the American Society of Addiction Medicine (ASAM), 1.9 million Americans had a substance abuse problem involving prescription painkillers in 2014. There were also 18,893 deaths related to prescription pain relievers.
A health-policy fellow at the UC Davis Department of Emergency Medicine, Dr. Nick Sawyer, believes patient satisfaction scores are leading to drug abuse…
"It's hard to make them happy without a narcotic," Dr. Sawyer stated. "This policy is leading to ongoing opioid abuse."
The CMS argues against any link between the surveys, a hospital's reimbursement money, and painkiller abuse. According to Time, agency doctors for the CMS stated that patient satisfaction scores only accounted for 30% of a hospital's total performance scores in 2015. Pain management was one of eight equally weighted factors in determining a hospital's reimbursement.
Despite CMS claims, lawmakers are questioning the program. Sen. Susan Collins (R-ME) saw a 27.3% rise in deaths caused by drug overdoses from 2013 to 2014.
"Health providers are telling me that these questions are written in a way that makes them fear a lower reimbursement if patients did not answer them in the affirmative," Collins stated. "For a small rural hospital in Maine to lose a certain percentage of their Medicare reimbursements is a big deal."
Congressman Alex Mooney (R-WV) introduced bill H.R. 4499 in February that gained bipartisan co-sponsors. It attempts to correct this misguided Obamacare policy…
According to the Promoting Responsible Opioid Prescribing (PROP) Act:
"This bill would remove an Obamacare penalty on doctors who refuse to overprescribe prescription painkillers. In doing so, this bill empowers doctors, not the federal government, to choose what is right for patients."
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- Time: How Obamacare Is Fueling America's Opioid Epidemic
- American Society of Addiction Medicine: Opioid Addiction 2016 Facts and Figures
- Mooney.house.gov: Drug Epidemic