Below is an article I wrote just over a year ago. It is absolutely just as relevant today, if not more so. It was originally posted here at GoArticles.com. In recent times there have been some states that are starting to at least require drug testing in order to receive specific public support. It is a start, but much, much more can be done, as you’ll see below.
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Health care reform has been such a frenetic topic in recent years with heated debates from both sides of the aisle in our nation’s capital, but few of the arguments have touched on one major way to reduce costs, improve productivity and reinvest the money saved into other areas of the budget.
The area in question is Medicaid. While it has helped millions of families with much-needed public assistance, there is a major downfall and abuse of the system. One is through drug companies lobbying to get high-priced drugs paid for by Medicaid (and then promoting doctors who accept Medicaid to prescribe those drugs more). The Congressional Budget Office (CBO) cites federal healthcare spending as “the single greatest threat” to the United States’ budget stability in its new report, The Budget and Economic Outlook: Fiscal Years 2010 to 2020. Combined outlays for Medicare and Medicaid currently equal about 5.5 percent of Gross Domestic Product (GDP). The CBO reports that under current law, spending for those two programs is expected to keep growing faster than the economy, reaching 6.6 percent of GDP by 2020 and potentially reaching 10 percent by 2035.
According to a report from the U.S. Department of Health and Human Services (HHS), the combined federal and state expenditures for Medicaid represented 0.4 percent of the economy in 1970, but this percentage grew to 0.9 percent in 1980, 1.2 percent in 1990, 2.0 percent in 2000 and 2.3 percent in 2007.
It’s not like there weren’t warning signs. One example is an article in the New England Journal of Medicine from February 5, 2004, which stated, “Prescription drugs are the fastest-growing component of health care spending. Medicaid has been hit hard…”.
The pattern is quite simple. Get a list of symptoms voted into the DSM as being a mental disorder so that there are insurance billing codes, develop drugs to treat these symptoms, pay off the FDA to approve the drugs, spend millions to lobby to elected officials for public funds to pay for the drugs and many millions more to tell consumers they need these new drugs while already having secured doctors in their pockets. Then develop some new drugs and disorders and repeat the process all over again once the patents run out. Make billions of dollars to settle lawsuits and still profit hundreds of millions of dollars in the end, regardless of the lives lost. This isn’t some theory, it IS what is happening.
On top of that, we have millions of people on Medicaid right now who are not only living off of yours and my tax dollars, but doing so while continuing to take illicit drugs. Real Medicaid reform would put tougher provisions in place to become eligible for Medicaid and reduce spending on pharmaceuticals. Senator Orrin Hatch from Utah is trying to push for drug testing for people receiving public assistance, which could work if the right system regulations were put in place.
Now, I don’t want you to think that I am anti-Medicaid, because that is definitely not the case. In fact, my family received financial help in the form of public assistance at one point when I was an infant, and I know there are millions of people who are deserving of the help and also working their way back on their feet. However, something has to change or our nation’s debt will continue to spiral out of control on this single point.
So here is something that I would propose to start to reverse some of this insanity:
Start by passing a law stating that all adults receiving Medicaid must pass periodic drug tests. In the event of a positive test for a banned substance, then they have the opportunity to attend a rehabilitation program paid for with public funding or another one of their own choosing. There could be a three-strike rule, with two chances at recovering through treatment and losing benefits on the third positive drug test, or something to this effect. This doesn’t mean the door would be shut forever, as they can re-apply for assistance after completion of another drug rehabilitation program and submitting clean drug tests for a period of at least 90 days. Any children involved would not lose their benefits, but they would be given to their caretakers in the interim.
This practice alone could save billions of dollars that could be used to fund other activities, including educational projects, job training, childcare, etc. It would also put more responsibility on the individuals receiving the help and going to treatment instead of relying on the government to take care of them in their condition.
Another adjustment would be that the addiction treatment centers receiving public funds should have to comply with a set of standards based on results, such as with a universal outcome monitoring system to demonstrate effectiveness (more on that later) and hold rehabilitation programs accountable for their services. This would increase the percentage of those who attend and complete these treatment centers of having permanent sobriety, and in many cases this would allow them to take advantage of other public programs for education and job training to begin earning enough income to not have to rely on public assistance.
The third reform practice to reduce Medicaid spending would be to cut prescription drug costs. This could be done by limiting the eligible amount to force drug makers to comply if their patent has not run out yet, so that spending would be equal to other drugs that already have generics at much lower prices. The prescription drug cuts would also include removing drugs that are given for subjective diagnoses, such as many behavioral disorders, without fully substantiated evidence. As covered earlier, these mental disorders are typically voted into the DSM with a series of symptoms, and diagnostic criteria loose, at best. I have seen patients with the same set of symptoms get 3 different diagnoses by three different doctors, all of whom put them on different drugs, when the symptoms were actually CREATED by drugs in the first place. This happens in the addiction treatment field very often, actually. Requiring some form of strict diagnostic testing for it to be covered may be a good idea, such as if it can’t be identified via blood test then it probably won’t be covered, or an equally verifiable procedure.