Document Type
Article
Publication Title
Harvard Law & Policy Review
Abstract
While insurers have both the power and the motivation to curb the practice of harmful opioid prescribing, they may go about it in ways that could be counter-productive to larger public health goals. After all, insurers have historically discriminated against addiction like any other condition that leads to costly healthcare consumption. In the past, insurers have avoided enrolling addicted insureds and have limited rehabilitation services. To address this epidemic, insurers might engage in ways that could harm third parties. For example, to the extent they are permitted, insurers might avoid addicted enrollees altogether, or might limit coverage of addiction treatments in order to save money. They may overcorrect, sharply curbing most opioid prescriptions and relishing the money saved, while ignoring the harms to patients who depend on this form of pain management. Or they might focus too much on curbing prescriptions because it is cost-saving, while focusing less attention on adequate addiction treatment, which costs money. After all, their broader goal is typically not to improve the public’s health, but to predict and avoid risk.
Insurers are already beginning to act on their own, for example by monitoring their insureds for opioid abuse and limiting opioids for some patients. Regulators need to be aware of insurer conduct and should monitor it for which practices are or are not likely to achieve positive outcomes in this public health crisis. While insurers must be engaged in this epidemic, they must also be regulated to ensure that their efforts help and do not harm the broader goals of preventing and treating addiction.
Publication Date
2017
Recommended Citation
Blake, Valarie, Engaging Health Insurers in the War on Prescription Painkillers (2017). 11 Harvard L. & Pol’y Rev. 487 (2017).