The Price We Pay: What Broke American Health Care--and How to Fix It

by Marty Makary

We also need insurance companies to change. Ironically, acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs) are over-the-counter medicines and thus rarely covered by insurance. But the insurers do cover narcotic painkillers. As I’ve talked to my patients, I’ve come to believe that one simple solution is that all non-opioid pain meds should be fully covered after surgery with no copay or deductible. Those who think that the $10 to $20 price for a bottle of NSAIDs is a not a barrier to patients buying them should meet some of my poor patients from inner-city Baltimore. I have had patients buy heroin to manage their surgical pain because it cost less than their copay. Finally, patients should inquire about having a nerve block when they have a painful procedure. It’s well established that when nerve blocks are injected in a surgical area or nerve root, patients require fewer pain pills. Hopefully, someday, physicians will be able to manage local pain with local therapy rather than systemic therapy, which has collateral damage.