The Opioid Dens of Medicaid

Today’s post is by guest blogger, Robert Detor, LCSW, a member of the board of the Association for Mental Health and Wellness.  The following column was submitted to the Wall Street Journal.


Robert Detor, LCSW

Everyone needs to be constantly discriminating when reading published information and this editorial is a perfect example of why “Fake News” needs to be taken seriously. That doesn’t mean everything is fake, but everyone must exercise a hyper alertness and understand the source. Often the sources will telegraph the intent and trigger alarms to dive deeper. This editorial is one of those pieces that demands further review. It unabashedly purports to implicate ObamaCare and Medicaid in the Opioid crisis and the resulting deaths. So many deaths that in fact the expected lifespan for Americans has decreased in the past few years!

The basis for your editorial is a report issued by Sen. Ron Johnson from the Senate Homeland Security and Governmental Affairs Committee. What you do not explain is this so-called report, from the Wisconsin Senator, who last week accused the FBI of having a “Secret Society” (like the Illuminati), was authored by the Senate Republican Majority staff. It is not a report from an independent bonafide research entity. Without such a disclaimer it is easy for readers to assume this is fact. Rather, it is interpretation and I would suggest biased.

You write that Medicaid offers cheap access to drugs (as if commercial plans don’t), for a low co-pay, then jump to some anecdotes to morally indict Medicaid beneficiaries complicit in a fraud to dupe unsuspecting pharmacists. Next is an admission “fraud is a feature of any government program” as you jump to a Bronx bodega and a cabal of health-care providers in Miami. (I don’t think you’re referencing the multi-million dollar fraud case of the healthcare company the Governor of Florida ran by Medicare?)

Next, the unbelievable distortion: Obamacare is to blame! Yes, you cite the report where there was a 55 percent increase in criminal cases filed between 2014 and 2017, compared to the four years before the expansion of health care. to the poor and middle class. So it appears there is a causal effect between the expansion of access for the middle class and poor to healthcare and crime?

There is no doubt the opioid crisis has severely impacted our country. The deaths during the past four years have soared; 64,000 deaths in 2016 according to the National Institute on Drug Abuse. NIDA reported synthetic opioids were the leading cause of death, with heroin, natural and semi-synthetic opiates, cocaine and methamphetamines also on the rise. It is a true epidemic of historic proportions. But the link Johnson’s report makes to the increased access to prescriptions doesn’t hold water. According to the National Institute of Health, overdose deaths by prescription drugs peaked in 2011, three years before Obamacare.

I suggest you take a look at the testimony provided at the June 8, 2017 Congressional Joint Economic Committee on the “Economic Aspects of the Opioid Crisis.” In this hearing, factual data is presented that states clearly those most impacted by the crisis are between 26 and 34 years old and historically had the least access to healthcare coverage. 51.4 percent of the people with an OUD (opioid disorder) have incomes below 200 percent of the Federal poverty level ($23,764 for an individual) and have not had access to coverage.  Also…Fact: the drugs fentanyl and heroin, the most frequent causes in overdoses, are obtained illegally, not by prescription or resale of drugs obtained by prescription. And to restate, NIDA clearly shows overdose by prescription drugs peaked in 2011, three years before Obamacare!

It seems to me that any publication with an ounce of integrity should restate its position based upon all the facts. This report by the Senate Majority was released not to further the cause of solving the horrendous problem of the lives being lost to overdose. If it was, it entirely misdirects our efforts.

So, should we wonder why this was released? Or even better, why were our taxpayer dollars used to produce such rubbish? And what was your real point?

Michael Stoltz has been at the agency’s leadership helm since 1990, first as Executive Director of the predecessor organization, Clubhouse of Suffolk, and since July 2014, the CEO of the Association for Mental Health and Wellness (MHAW). MHAW is the result of the merger of Clubhouse with Suffolk County United Veterans and the Mental Health Association in Suffolk County.                                                                                                                                             Under Michael’s stewardship, the agency has grown to one with an $10 million annual operating budget, 150 employees, servicing more than 3,000 people each year through its Ronkonkoma, Riverhead, and Yaphank facilities. A social worker by training, Michael received his MSW in 1982 from Adelphi University, where he has served as an Adjunct Professor teaching Social Welfare Policy and Human Service Management. He served as a Program Supervisor, developing and implementing the Suffolk County Intensive Case Management Program, as well as positions in management and direct service at several Long Island outpatient clinics.

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Posted in Addiction, Affordable Care Act, Opioid

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