Saturday, May 13, 2017

Purposely injuring yourself to get drugs

In the new book, Passion for Patients (, Dr. Lee Beecher and I included a few stories about patients with whom he and/or I had come in contact – true stories, but without identifying the person. This is one of those true stories. I hope it shocks you.

Before you read this, ask yourself what you know about an addict’s desperation. How far would a person go to get drugs to feed his or her habit? I am sure you will agree, after reading this, that addiction is an evil curse that thoroughly destroys lives – and unless you know an addict, you might never believe how it drives such negative behavior.

Lynn, a middle-aged single female, presented to the Emergency Department with serious burns on her leg. The burns extended from her right knee down to her ankle and had spread across the width of her calf. Lynn expressed extreme pain – at least a 10, she said.

The medical intervention was clear enough. Reducing the pain, of course, resulted in an opioid prescription which the staff administered, and it included two powerful painkillers for each administration of medicine. The staff did not notice that Lynn only swallowed one of the pills, and hid the other in her blankets. She gave those hidden pills to her partner who visited her constantly during her hospitalization.

Lynn suffered third degree burns. She self-reported that she had taken a pot of boiling water from the stove and the handle twisted. The boiling water hit her leg and caused the burns.

Upon discharge from the burn unit two days later, the hospital gave Lynn a script for 80 opioid painkillers. By the time she had arrived home, her partner had already bartered away 24 of them to obtain her own stash of mind-altering drugs. A day later, Lynn’s leg began blistering and needed to be regularly scraped.

In terrible pain, Lynn returned to the burn unit, was readmitted for two more days, and over time, secured a second script for opioids. She had to continue to scrape the blisters on the burned area for several weeks.

Months after the incident, Lynn confessed that the “accident” of pouring boiling water on her leg was no accident. Her partner had done it on purpose, solely so that the two could obtain opioids – paid by Medicaid.

The United States has an opioid epidemic that delivers death, destruction, and terrible suffering. In 2013, the Center for Disease Control reported that more than 47,000 deaths in the U.S. were attributed to drug overdose. CDC and medical professionals say we are experiencing an “opioid epidemic.” The rate of drug overdose deaths in 2015 in the U.S. has spiked 2.5 times since 1999, to 16.3 deaths per 100,000 people.

Lynn knew that when her partner poured boiling water on her leg it would painful, but to those two, nothing was more important than getting more drugs. Nothing.

The tragedy of addiction is written out each day by individuals whose choices destroy their lives and create incredible suffering for those who love them.

I’m betting you know someone, or are someone, who has experienced, or is still experiencing the pain of addiction.  

Friday, May 5, 2017

Avoid winning the lottery - you will lose your free healthcare

An amazing 6% of the pages of the new House-passed “healthcare” reform bill (some 175 lines) is devoted to disqualifying individuals from Medicaid who win lotteries, provided that the amounts they win exceed [lots of conditions] and it’s not meant to penalize others who are eligible in the same household.

Medicaid is a state and federal program intended to provide healthcare services to low-income individuals. But if you win the lottery, so goes the GOP House’s reasoning, you should be able to buy your own health insurance. I expect you agree with that, right?

But this exposes one of the greatest flaws of the now-dying Affordable Care Act of 2010. The ACA opened up enrollment for millions of individuals into taxpayer-paid coverage under Medicaid regardless of how much money that person has, houses owned, cars in the garage, or boats on the lake. Conceivably, under the ACA, a Medicaid recipient can have millions in assets and still receive taxpayer-paid healthcare.

The ACA had many flaws, but to me, this is among the most egregious. Why should taxpayers have to pick up the medical bills of people who have tens of thousands, or more, in assets, while working people have to not only ante up for insurance premiums, but also to pay higher taxes to provide free coverage to rich people?

It appears that if HR 1628 (the bill the Federal House of Representatives passed on May 4) were to move forward as is, those Medicaid enrollees with high valued assets will still qualify for taxpayer-paid healthcare coverage – and that is wrong. Of course, these individuals will have to quit buying lottery tickets, or they might lose their coverage.

CONSTITUTIONAL FOOTNOTE: What no one seems to want to challenge is the fact that there is no explicit enumerated power in the United States Constitution that gives the federal government any authority to write legislation that deals with individual healthcare. But who cares about the Constitution anymore.