|The Dangerous Servant
By Bob Starrett
Of all the baloney that has come out of the various battles in medical marijuana states, the notion that “anyone” can get a medical marijuana recommendation from a doctor is the scariest to legislators who are considering medical marijuana bills in their states this year.
In 2012, 17 states have pending medical marijuana legislation. And you can be sure that this argument — that chronic pain is used as a catchall for doctors to hand out medical marijuana recommendations to “anyone” — will come into play as it has in Montana and New Jersey.
In an apparent attempt to prevent wholesale stoned-ness among the citizenry, New Jersey specifically excluded chronic pain as an eligible condition in their legislation.
Last year, the Montana Legislature, having failed in their attempts to repeal the state’s medical marijuana law entirely, made significant changes that included specific doctor rules for a chronic pain diagnosis. A recommending physician must have either x-rays or an MRI to back up the diagnosis. If they do not, a second physician must sign the “Physician Statement for a Chronic Pain Diagnosis.” It is a separate form.
Chronic pain sufferers are second-class citizens in Montana — and it’s as if they’re not citizens at all in New Jersey.
|Barry Lessin, M.Ed., CAADC
Oh, chronic pain. While various medical marijuana programs use different phrases, chronic pain — chronic and severe pain, severe intractable pain, call it what you will — it is difficult to ignore it as a national health issue.
According to the Institute of Medicine, which the New York Times called the nation’s most esteemed and authoritative adviser on issues of health and medicine, “Chronic pain affects an estimated 116 million American adults–more than the total affected by heart disease, cancer, and diabetes combined. Pain also costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the IOM in examining pain as a public health problem.” So you would ignore chronic pain as a real national health issue at your peril.
Chronic pain is a fairly common occurrence with soft tissue injuries and many soft tissue injuries do not show up on MRIs or x-rays. That is why insurance companies have made a good living for many years by using that fact in court.
|American Association for Justice
Allstate and State Farm are good and perennial examples of this. In the 1990s they hired McKinsey & Company, the CEO boot camp that produced Jeffrey Skilling of Enron fame and several other not-yet-indicted big name CEOs, to identify legitimate claims that could be profitably denied.
Of course, many of those were soft-tissue injuries from automobile accidents. Where there was minimal damage to the victim’s vehicle, the plan was known as the “3D rule”: Deny, Delay and Defend.
The first two Ds are common. The third, Defend, was used to let attorneys know that they would defend cases where the claim was as low as $15,000 or less, making it less likely that accident victims could find proper representation.
When they had to defend they would make a big issue of the condition of the vehicle, essentially arguing that considering the minimum vehicle damage the victim could not have suffered the claimed soft tissue injuries because gosh, they don’t show up on x-rays or MRIs.
Indeed, the chronic pain diagnosis is the most common for medical marijuana cardholders. That makes sense in light of the IOM’s statistics.
Do people abuse the system? Yes, they do — not just with medical marijuana, but also with Oxycontin and Valium, Xanax and the host of other chemical treats supplied by Big Pharma.
Do doctors risk their livelihoods by handing out medical marijuana recommendations for 50 bucks? Some have, others will — but most do not.
Despite “Obamacare,” Gallup finds that 17.1 percent of Americans did not have health insurance in 2011 and that is up from 14.8 percent in 2010. So, if you live in Montana and have chronic pain and no health insurance, that x-ray or MRI is on your dime.
If you do have health insurance, you are probably no better off. And if you live in New Jersey, forget it, no matter how many dimes you can save. Two years after the passage of the medical marijuana legislation there, neither leaf nor nor twig nor bud has been available to any patient. When New Jersey does finally get it together, chronic pain patients will still be out of luck.
So with 116 million adults suffering from chronic pain, however described, affordable and appropriate pain relief seems like an important cause. Let’s just hope that as these 17 state legislatures consider their respective bills, that they not fall prey to the Boogeyman that is chronic pain.
When they hold their hearings this year, let’s hope that we don’t see witness panels like we saw last week on Capitol Hill with a panel of five male witnesses to testify about …birth control.
But I can see it now: Committees of clueless old white men calling a panel of stooges who were sent in to lie to a doctor to testify that “anyone can get a medical marijuana card.”
Let’s see if they have the foresight to call a few relevant witnesses. Like maybe some people with chronic pain.
Editor’s note: Bob Starrett, with 22 years of experience with Optical Disc and Drive technology, is the author of six books on CD and CD-ROM technology, and his published magazine work includes more than 250 articles, reviews and columns on CD-ROM, CD Recordable, DVD-ROM and DVD Recordable technology for publications including PC Magazine, EMedia Magazine, CD-ROM Professional, Digital Video Magazine, Digital Content Creator, One To One, Online, Tape-Disc Business and others. He holds a J.D. from the University of Colorado School of Law.