A good deal of air is exhaled over the state of medical care in America.
Open
state worshipers want a complete government takeover, while a more
subtle band of state worshipers, those who call themselves
advocates of limited government, propose instead to use market
incentives to accomplish their aims. What neither party wants is
to
let free individuals choose their own aims, applying their own means
(incomes) to accomplishing them.
The pseudo-debate is useful to the pseudo-debaters, that is
because it keeps peoples minds off the real government-induced
medical scandals, of which there are many.
For example, if you look carefully, you will learn that people who
suffer
chronic pain are routinely undertreated because their doctors fear that
the
U.S. Drug Enforcement Administration (DEA) will accuse them of being
drug
pushers, destroy their practices, wipe them out financially, and throw
them
in jail for good measure. This is no exaggeration. Doctors have even
been
charged with murder when a patient dies an apparently drug-related death.
The most recent case involved Dr. William Hurwitz of Virginia, who was
convicted in December of 50 drug and conspiracy charges. Possible
sentence: life in prison. What did he do? He treated many chronic-pain
sufferers with opioids. The government claimed that a small percentage
of
them were faking and didnt need the drugs. Some
might have sold them in the black market. The prosecutors did not argue,
much less prove, that Hurwitz actively conspired with anyone. Rather,
they
relied on a tacit-conspiracy theory, counting on the drug-hysterical
jury to
convict. They were not let down.
But this was only the latest travesty. Of course, the convictions are
noticed
by other doctors, who either stop treating chronic pain altogether or
undertreat it in order to avoid the governments talons.
Lets pause to reflect: our all-wise and all-benevolent government
has
brought about a situation in which people with long-term pain have
little
choice but to suffer because their doctors live under a reign of terror.
When was the last time you heard your compassionate president, senator,
or
representative mention that?
The answer is never. In fact, what you hear are new commitments to
redouble the so-called War on Drugs, which is really a war on drug
consumers
including chronic-pain sufferers.
It was inevitable that drug prohibition would seriously affect the
practice of
medicine, all assurances to the contrary notwithstanding. And you
thought
prohibition would merely deprive junkies of their fixes. So goes the Law
of
Unintended Consequences.
The head of the DEA says there is no reason that good doctors should be
hampered by its efforts. Karen Tandy pledges that her goal is to
ensure that patients with legitimate need have access to pain
medications
that relieve suffering and improve quality of life.... Doctors acting in
good
faith and in accordance with established medical norms should remain
confident in their ability to prescribe appropriate pain medications.
But as Reason magazines Jacob Sullum points out, that
is no assurance at all. The DEA decides after the fact
what
legitimate need means, whether established medical
norms are followed, and whether the prescriptions are
appropriate. When you go the doctor, a prohibition agent is
looking over his shoulder.
What could possibly be worth this cost? The prohibitionists will say
that
opioids are addictive. But Dr. Jane Orient, executive director of the
Association of American Physicians and Surgeons, writes, Today,
there is considerable evidence that patients rarely, if ever, become
junkies
because of using opioids for pain relief even though they are as
dependent on the drugs as heart patients may be on their heart
medicine....
The drugs have been literally lifesaving in countless patients who might
otherwise have administered a gunshot wound to their head or suffered a
fatal one-car accident.
The war on drug users and doctors is the product of a totalitarian
mentality.
People should be able to buy whatever drugs they want, subject only to
the
principles of self-responsibility and liability. Doctors should be able
to give
their best advice to patients without fear of being second-guessed by
prohibition agents. Until then, the government is indistinguishable from
our
enemy.
Sheldon Richman is senior fellow at The Future of Freedom Foundation, author of Tethered Citizens: Time to Repeal the Welfare State, and editor of The Freeman magazine. Send him email.
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