Here's a tweet from Sen. Kirsten Gillibrand (D–N.Y.), who is running to win her party's presidential nomination. This should bother anyone who thinks that doctors should be able to treat patients without running everything past Congress. It's also a premonition of what to expect if a national single-payer health plan such as Medicare for All ever gets fully implemented (Gillibrand supports Medicare for All).
If we want to end the opioid epidemic, we must work to address the root causes of abuse. That's why @SenCoryGardner and I introduced legislation to limit opioid prescriptions for acute pain to 7 days. Because no one needs a month's supply for a wisdom tooth extraction.
— Sen. Kirsten Gillibrand (@gillibrandny) March 15, 2019
Any number of things about this tweet and the legislation it's pushing are just terrible. The certitude with which Gillibrand speaks is terrifying, especially given her lack of medical training. That it's bipartisan underscores the notion that the only thing worse than a gridlocked government is one in which Democrats and Republicans actively work together (Cory Gardner is a Republican senator from Colorado).
And then there's the reality that "punishing patients won't reduce opioid deaths," as Reason's Jacob Sullum wrote in December, when a new Medicare rule lowered the amount of medicine that could be dispensed in a given prescription:
Opioid prescriptions, measured by total [morphine milligram equivalents], have fallen by a third since 2010, while opioid-related deaths have more than doubled. Instead of reducing deaths involving opioids, the crackdown on pain pills has pushed nonmedical users toward black-market substitutes, which are much more dangerous because their potency is highly variable and unpredictable.
The Trump administration wants to cut opioid prescriptions by another third in the next three years. What could go wrong? We already know.
As Sullum has documented again and again, restricting access to prescription painkillers has left patients in agony while pushing people with abuse issues into more dangerous and deadly situations.
Because of its size, Medicare already sets too many prices, regulations, and practices in the delivery of American medicine. If and when it expands to cover the entire population, you can expect not just a profound level of dysfunction based on how it already operates but ever-increasing political grandstanding along the lines of Gillibrand and Gardner's intervention into the doctor-patient relationship.
In 2017, Paul Detrick and I explained what's wrong with the Medicare for All plan from Sen. Bernie Sanders (I–Vt.). Take a look: