Tooth extraction markets in everything

Dozens of medical professionals in seven states were charged Wednesday with participating in the illegal prescribing of more than 32 million pain pills, including doctors who prosecutors said traded sex for prescriptions and a dentist who unnecessarily pulled teeth from patients to justify giving them opioids…

Another Alabama doctor allegedly prescribed opioids in high doses and charged a “concierge fee” of $600 per year to be one of his patients.

By Sari Horwitz and Scott Higham, there is more of interest at the link.  For the pointer I thank Harrison Brown.

Comments

The tooth-pulling: that's getting into "Les Miserables" territory. Nevertheless, surveying this country, what we need is more drugs.

When we go down it will not be due to the Russians or Chinese, but because we are junkies.

I am *massively* skeptical of the "pulling teeth as an excuse to prescribe opioids" line. BS pushed by the police/prosecutors to make good copy.

Yeah, I immediately channeled that unfortunate soul, "Hold up, is this really necessary? I think my friends got the prescription without ... is this really best practices?"

Maybe it was reserved as a sort of punishment for people who didn't have enough cash, to encourage them to convert shoplifted Walmart goods into pills, per Sam Quinones.

Still, I don't think our inability to conceive of it, necessarily signifies.

America has become morally rotten.

Big reveal: they were criminals

Exactly. Like Al Capone, Bonnie and Clyde, William M. Tweed, John Dillinger, Billy The Kid and Tony Montana. America is now controlled by gangsterism writ large.

I come not to trivialize the fatal, mass opioid crisis. When I was cut loose after bilateral knee replacement surgery (ouch), I asked the MD what pills to take besides the prescribed opioid. He recommended extra-strength Tylenol, which has the same analgesic potential. That is what I did.

Additionally Thiago, most of those named have in common that they are dead. Tony Montana is a movie caricature.

shockingly, I agree. America is now controlled by weak people who can't take a little pain and vote for losers like Crooked Hillary, Barack Hussein Obama, Alexandria Occasional Cortex, Adam Schitt.

"When I was cut loose after bilateral knee replacement surgery"
I hope you are better.

"Tony Montana is a movie caricature."
Which was based on America's pressing gangster problem.

"Additionally Thiago, most of those named have in common that they are dead."
Which were replaced by other gangsters, biggler ones. As famous American General Smedley Butler said, "Looking back on it, I might have given Al Capone a few hints. The best he could do was to operate his racket in three districts. I operated on three continents."
I have read that American companies, such as Purdue Pharma, make Americans become adict on opioids to make more money selling more opioids to them. I can not imagine Brazilian companies doing that. I can not imagine the Brazilian government allowing it to pass.

""Tony Montana is a movie caricature."
Which was based on America's pressing gangster problem."

No. Which was based on a very fanciful, exaggerated, and fictional caricature. It was a fright movie, plain and simple. You know, horror? Brain-eating zombies? Remember how people got all freaked out over Exorcist? People walked out of the theater BELIEVING that fictional crap like that could be real? Never ceases to amaze.

It is not that simple. There is more than meets the eye. Evidently, movies dramatize exagerate social problems. Authorities, though, must act to make sure problems can be controled and solved. When a string of deaths involving RPG games happened a few years ago, several Brazilian cities banned RPG games.
The point is, America has a long and disturbing tradition of gangsterism. I have read about Al Capone, The Bloods, The Crips, Tammany Hall, the Triads, the Five Families, etc. Many Brazilians watched the American Movie Scarface, Shame of a Nation. https://en.m.wikipedia.org/wiki/Scarface_(1932_film)

Placebo effect at work

You forgot career criminal and accused rapist Dotard Trump!

Parody account?

We just let Dick indulge his Dem Derangement Syndrome. It gets things off his chest and lowers his blood pressure.

Nay nay nay: America has become "morally sophisticated".

Traditional moral and ethical discourse and diction have all been buried under the accumulated weights of modernity and Holy Science: "should", "must", and "ought" have no ethical or linguistic force--these traditional terms only suggest moral content, but the suggestions amount to no moral substance beyond mere preference.

American "morality" and American "ethics" now consist only of the guidance adapted from applied science and applied technology: "CAN" (the mere ability to do, as long as one can evade detection and/or apprehension after the fact) is the only categorical imperative with any moral force in the US in 2019.

It is so sad.

Favela sad? Or "people getting arrested on bullshit charges" sad?

Don't get me wrong. All those medical "professionals" need to lose their license to practice forever and arrested if they've committed insurance or Medicare fraud. But getting arrested for providing an in-demand product to adults? That's really sad. Not quite as sad as creating a culture of corruption that dooms generations to living in favelas, but still kind of sad.

Let us be blunt. They broke the Law and helped people to break the Law. Theybare criminals.

And possibly morally rotten.

Exactly.

The law is the crime. It deserves to be broken.

No, it is not. As President Captain Bolsonaro says, the law must uphed, criminals must be caught.

The corruption of American dentistry by corrupt and corrupting pharmaceutical companies gives us (however apt) the working metaphor of "American toothlessness".

What a pity that caring American clinicians and therapists of the Boomer cohort became so susceptible to industrial-scale corruption, in spite of all the heady idealism and moral certitude they raised themselves with.

Remarkable to blame it on boomers and their ideals when this is so clearly the result of 1980s rabid market fundamentalism — where profit is the only moral value.

Who was in position to profit from "1980s rabid market fundamentalism" like the newly-credentialed, newly-hired Boomers?

Boomers were very sure of themselves as the 60s ended, on into and through the 70s: hard to imagine how their heady idealism and moral certitudes somehow failed them spectacularly as they took the reins of governance and market performance from their parents. (I don't think their parents' tutelage itself can wholly account for whatever misdirections they wound up taking for the country and for themselves: Boomers need never be shy or coy, they merit a lot of credit all by themselves for the choices they made for all of us.)

"Sex for drugs" meets a certain free market ideal, but most Americans are not ready for markets that "free."

We prefer markets with guard-rails.

Careful. Doctors are artificial gatekeepers created by law. We merely need their prescription to buy drugs from pharma companies who actually produce them and distributors who actually deliver them. And we only need those prescriptions because government has declared it mandatory at gunpoint.

These doctors didn't exchange sex for drugs, they exchanged sex for the permission papers only needed because government demands we get them, so that we can get them from the entities that do the actual production and delivery.

In a truly free market, asking doctors for their opinion would be completely voluntary for the patient.

The second "get them" refers to the drugs, not the papers. Sorry for the confusion.

My point is that this is worse than "sex for drugs", it's "sex for the artificial scarcity government forces on people"

Wait, you are saying that without criminal penalty there would be _less_ sex for drugs exchanges?

Buddy, even without the gatekeepers there are poor and desperate people. Some of those want drugs.

Less sex with doctors, more sex with pharmacists.

It was about time. File under "the US is underpoliced".

Can't tell if parody or actually retarded.

How dare they give people what they want!

Then, they force people to abuse it, ruin their lives, commit suicide . . .

I've got it!

Legalize weed (And tax it!).

Brilliant!!!

When were they forced? Oh right never.

Trading sex for pills, like any other barter system, is less efficient than cash. Pulling teeth to justify selling pills is less efficient than taking cash. Tyler is objecting to this unnecessary friction in the market.

Except doctors don't sell pills - they sell prescriptions. They are peddlers of artificial scarcity created by law. They have no idea how to make the pills, and they add no value to the process of production and delivery.

Also, some people go to the doctor to get opioids because they're addicted, but others go because they're actually in chronic untreated pain. Make it easy to get opiods, and chronic pain sufferers are better off but more people get addicted; make it harder to get opioids and fewer people get addicted but more chronic pain sufferers commit suicide to escape their unrelenting unbearable pain. This is a tradeoff we don't know how to avoid.

We can pass laws to make it really hard to get opiods from a doctor, and we can do enforcement actions like this that convince most doctors to refuse to prescribe opiods in any questionable cases. But we can't fix that nasty tradeoff.

It seems very unlikely to me that state legislatures, police agencies, or congress will do a good job choosing a sensible point on that tradeoff, and very likely that they'll do a lot of collateral damage in their attempts to signal how very seriously they take the opiod epidemic.

I don't understand what "markets in everything" means.

That's okay, hun. Keep working at it.

The opioid 'crisis' is wildly overblown and the problem isn't people getting pills for their pain. Indeed the real problem is that people with pain are finding it harder to get pills they desperately need to function because of this neo-ascetism that asks people to serious 'manage' pain that is unbearable.

I think a big part of the crisis involves fenanyl (a synthetic opioid that's much more potent than heroin). This either gets sold directly or gets mixed into other black-market opiates/opioids and sold, and then the customers overdose and die and show up in death statistics.

USA Today names and shames the doctors involved: https://eu.cincinnati.com/story/news/2019/04/17/illegal-opioid-prescription-sweep-list-doctors-pharmacists/3495209002/ - why does WaPo omit this info?

I'm trying to figure out why you often label "crime" as "markets". I'd worry about having a moral blind spot that big.

The only crime is prohibition.

Even for simpleminded slogans that's a really stupid one.

Demand for psychiatric drugs is the same whether it’s turned towards psychiatrists or MDs. No idea how the supply side restrictions work but are we shocked that the prices converge?

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