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Nate Strauch | The pain game

Finding yourself in a predicament whereby you’re forced to come into contact with the American health care system is the very definition of a lose-lose. You already have a serious problem, or you wouldn’t be at the hospital in the first place. Very likely, you’re in pain. And you know there exists all these tremendous substances of chemical amelioration that could make you feel better. But in order to possess and ingest one of those substances, you have deal with a bureaucratic system that seems purposefully designed to prolong your suffering.

The bulletin board on the wall of your hospital room says “Pain management is our goal!” but really it’s not. Pain management is your goal. The hospital’s goal is not running afoul of government regulation. And therein lies the problem.

We still think of doctors and the institutions they function within as endeavoring to fix what’s broken, but that notion might be as antiquated as the lobotomy, and just dumb, too. Of course, most doctors are still good people who want to do good things, but the amount of regulations surrounding health care has left the modern doctor more akin to a DMV employee than the healers they were not so long ago.

At the heart of the matter is the prescription drug trade, which has been laughably over-regulated to protect people from themselves, to protect drug companies from lawsuits, and to protect addicts from their muse. While all three of those justifications might make sense in theory, in application they’ve made doctors into middle-men in what should really be a simple transaction between a drug company and a customer.

In a perfect world, keeping Oxycontin behind the pharmacist’s counter would prevent people from becoming addicted. But here we are in the real world, where, despite the over-protection administered by doctors, prescription drug abuse is allegedly the fastest growing drug problem in the country.

Regulating hydrocodine hasn’t kept people from abusing it, but what it has done, very effectively, is prevent easy access to pain meds for those who are, you know, in pain.

Why should society, generally, and patients, specifically, suffer because a small portion of people choose to abuse a product? And why should health care professionals be worrying about the illicit drug trade in the first place? Isn’t that law enforcement’s job?

Imagine if we tore down all those pharmacists’ counters Berlin Wall-style, and made the marketplace for legal drugs truly free. Think of the costs we’d dodge by eliminating millions of emergency room visits every month by people who just want not to be in pain. Ponder for a moment all the good that doctors could do if they didn’t spend their days playing nanny for the FDA.

It wouldn’t be a perfect world, to be sure. There would be more drug-related deaths, more meth cooked with easy access to pseudoephedrine, and more physicians addicted to Candy Crush because of all the free time on their hands. But we tend to focus far too much on the negative crusts in a debate like this instead of the massive amount of good that constitutes most of the pie. We miss the forest for the relatively few bad trees.

Everybody from the president to a ditch digger knows the American health care system has itself become malignant; it doesn’t take even five minutes in a hospital to come to that conclusion. But shuffling “Who pays the bill” through Obamacare or implementing electronic records or giving everyone an HSA isn’t going to fix things — it’s replating the Schwarzsauer aboard the Hindenburg.

Real reform would be a drastic stroke like ending prescription-only medicine. Real reform would give people the freedom to educate themselves, treat themselves and remake the system for themselves. Real reform would leave the emergency room for emergencies and move “pain management” into the free market.

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