HMO Hitmen and the Profits of Heroin Addiction
Irwin Ozborne, Contributor
“Susie is dead.”
I still remember the text message on that fateful morning.
“Susie is a 24-years-old, hard-working, good-looking girl without an enemy in the world. She is the type of person who naturally connects to everyone and genuinely cares about others. How could she be dead?
“She died from a heroin overdose.”
I heard these words and it literally floored me. We hear the figurative expression of being brought to your knees – well this is where it comes from. It literally occurs when you cannot physically stand and the pain and anguish is so unbearable that you involuntarily sink closer to the earth.
Who does heroin? That was my instinctive reaction.
It must have been engrained in our culture and generation that if you touch the stuff, you instantly die. But, in a way, that is not too far from the truth. Heroin is back and stronger and cheaper than ever previously known. And what comes with that is a desensitized public attention and understanding of our nation’s most recent drug epidemic – Heroin 3.0.
Beginning of the Epidemic:
In 2013, an average of 23 people in America died from a Heroin overdose each day.
Heroin is a drug on the other side of the gateway, with preceding drug abuse swinging the gate open. According to a 2013 SAMSHA study, nearly 80-percent of new heroin users had previously abused opiates.
The United States is home to just five percent of the world’s population, yet we consume 80-percent of the world’s prescription drugs – primarily opioid pain killers.
And this is where our epidemic begins.
Eighty-five percent of households in America have prescription medication in their house. Most of this medication is not locked up, typically found in the bathroom medicine cabinet. The ease of obtaining prescription drugs legally is a joke, but perhaps more disturbing is that fact that it is easier to get them illegally.
This is called supply. When supply is up, prices are cheap. When prices are cheap, new customers are found. With new customers, it increases demand. If this sounds like I am describing how to operate a for-profit business, I am. This is the for-profit business of legal drug dealing.
“Justice will not be served until those who are unaffected are as outraged as those who are.”
In the 1990’s there was a shift in the way pain was treated in hospitals. They used to only use morphine-based substances for major surgeries. But the hospitals were in agreement that they had been doing a terrible job treating pain and the consensus was that pain needs to be addressed with each client and monitored as a vital sign. Then this trickled down into primary clinics and it became our God-given right to have our pain needs met immediately.
Side Effects May Include…
We know the names of these drugs – Vicodin, Percocet, Oxycontin – because we have been bombarded with advertisements for the past 20 years. It started with the 1997 FDA Modernization Act, allowing drug companies to advertise directly to consumers.
The United States and New Zealand are the only two countries in the world that allow this ridiculousness. The laws previously stated that all side effects must be included, but that is not possible with the number of side effects of drugs toppling the thousands. Instead, they are only required to list a few of the side-effects “that may include…”
This led to pharmaceutical marketing blitz of the late 90’s. Patients flooded clinics demanding new drugs and doctors felt pressured to take out the prescription pad. Because, if doctors were to “just say no” to the patient, they lose business. The inmates were running the asylum.
In 2012, more than 41,000 Americans died from a drug overdose – including 16,000 from an opioid analgesic (300-percent increase since 1999). Meanwhile, sales on painkillers alone have topped $1.3 billion in 2013 – preventing any desire for the legal drug cartels to pull back the reins on this gravy train that is destroying a generation.
With an astonishing number of overdose deaths reported each year over the past 20 years, eventually congress had to act on this self-induced epidemic. Programs were put into place to discover who was overprescribing medications – known as “pill mills.” While well-intended to put an end to the unexpected surge in overdose deaths, this system also became available to the legal cartels. Pharmaceutical companies used this information to help increase sales by finding patterns in physician’s prescribing tendencies and knew which doctors to target. Top salespeople were sent to clinics utilizing the finest tricks in the book – free gifts, vacations, sporting events, and free samples.
Laws were finally put into place to reduce prescription practices to risky clients, along with mandating education programs to health providers on how many prescriptions they were signing.
Slowly, the supply in the general public is shrinking but the problem is we already created record-high demands for these drugs. And, when the demand is strong enough in any industry – people will find an alternate supply.
It is more potent than any pain killer on the market. In many cases it is easier to obtain and oftentimes cheaper. Basically, we created a demand for a product and then increased supply to fill that demand. Then the new laws took the away the supply, leaving a huge unmet demand for a product.
History of Heroin
Around 10,000 years ago in ancient China, the indigenous poppy plant was sliced open and they discovered a white-milky substance. When ingested, this substance gave intense feelings of euphoria and pleasure.
Primarily used as a spiritual ritual and then as medicine for pain in ancient Greece, opium eventually made its way into the public realm and was used recreationally. This led to early preaching against the drug and efforts to encourage recreational use in moderation as early as 160 AD.
In 1492, Christopher Columbus brought tobacco back to Europe which introduced a new method of administration. In smoking any substance, it is in direct contact with your lungs and then rapidly enters the bloodstream, bypassing the liver and gives a much more intense high at a quicker rate.
This helped fuel the opium epidemic in China in the 1800s. The British Empire grew opium in India and sold to their Chinese neighbors to the east. China had an alarmingly high rate of opium addiction at this time and the emperor attempted to ban the substance on multiple occasions.
But state-sponsored drug dealing is lucrative business. Drugs are ridiculously cheap to make and the mark-up is astronomically high. Some estimates report as high as 17,000-percent profit margins! And when we are talking that kind of money, fines and legal expenditures can never alter the way these products are pushed to the public. Two wars were fought between Britain and China over the opium trade, but with an advanced military the Brits won both wars and were allowed to continue to sell opium to a nation that saw over one-third of its total population addicted.
Technology continued to evolve the drug in Germany as scientists discovered the curing molecule of Opium – Morphine. This became the world’s new “magic drug.” It became a popular medication in the United States during the Civil War for the ailing soldiers in the battle field. However, even the strongest pain killer in the world was not acting fast enough to ease the pain and shock of wounded soldiers. Leading to another technology shift – the hypodermic needle; the newest method of administration to quickly get the drug into the bloodstream.
This led to the “Army Disease,” referring to civil war veterans that came home addicted to Morphine and a drug epidemic was rampant throughout the country. It turns out, not only is morphine addictive, but is the most addictive drug known to man.
Then the Bayer Company in Germany synthesized morphine further – developing the world’s newest “magic drug.” Heroin was introduced in 1898, and made available to the public while being deemed non-addictive, a cure for morphine addiction, and no side effects.
In less than a decade the negative effects of heroin were glaringly obvious. In 1914, the Harrison Tax Act placed major restrictions and by 1925 heroin was forever banned – just 27 years after celebrating the title of “magic drug.”
The demand for heroin slowly faded along with the supply. Mandatory sentencing laws also turned the public off to the drug and it stayed that way for about 50 years. It wasn’t until the 1970’s that the next wave of heroin use arrived in America.
The War on Drugs
It was an interesting time in America. The country was divided by the war in Vietnam, kids were being drafted to serve in the military and fight a war they knew nothing about. People stopped believing the government, and with good reason, as we were fighting secret wars in Laos, Burma, and Thailand – an area known as the “Golden Triangle.”
The Golden Triangle produced 90-percent of the world’s opium during the time of American occupation from 1954-1974. A secret war, with a secret army, needed a secret airline. Air America is the name of the CIA’s owned and operated airline in which its fleet supplied arms and ammunition to the rebels and insurgents of the Golden Triangle to help fight the war in Vietnam. In exchange, Air America transported opium grew by the Hmong farmers to the area and made its way to South Vietnam and sold to American Soldiers.
In 1971, Richard Nixon declared the “War on Drugs.” The war is still active today, making it the longest war in the history of America. While much is to be said about this complete failure, its beginnings stemmed from the soldier’s addiction to heroin in Vietnam.
The Nixon campaign launched “Operation Golden Flow” before ending the war in Vietnam. This was an effort to get the soldiers clean before coming home. Just like the civil war, this was a generation of soldiers addicted to a derivative from opium.
This newfound control of the world’s opium production gave Americans a peak in supply, and as history repeats itself, a demand would surely follow back home with Heroin Epidemic 2.0 coinciding with the Vietnam War and military occupation in the Golden Triangle.
American withdrawal from the Golden Triangle subsequently slowed the heroin epidemic of the 70s. And the “War on Drugs” found a new target in South America, in which the CIA empowered dictators that favored American corporations. Drug trafficking, and the huge profit-margins, ran under the cover of “War on Drugs,” led to an increased supply in cocaine and crack during the 1980s.
At the same time, there was also a new switch in the world’s leader in opium production – the “Golden Crescent.” This is an area is Central, South, and Western Asia defined by three countries – Iran, Pakistan, and Afghanistan – with Afghanistan being the world-leader in opium production since 1991. During the 80s, the CIA funded a group of rebels – involved in the opium trade – to fight off Soviet occupation in Afghanistan. One of those rebel groups funded by the CIA is known as “The Taliban.”
Dr. David Musto, a member of the Carter administration’s drug advisory board, issued a prescient warning that the United States was moving “into Afghanistan to support the opium growers in their rebellion against the Soviets. Shouldn’t we try,” Dr. Musto asked, “to avoid what we had done in Laos?”
In 1979, the DEA agreed with Musto and already anticipated huge shipments from Afghanistan to reach eastern shore of the United States. To give perspective on how supply/demand work in the drug industry along with profit margins, during the Soviet-Afghan War, annual heroin sales in Pakistan peaked at $8-$10 billion – about one-fourth of the country’s total GDP. At the same time, the rates of addiction increased by 26,000-percent! Just 5,000 reported cases of opium addiction in 1980 up to 1.3 million in 1988.
The CIA’s control of the Golden Crescent put America in control of the world’s opium production again. The formula stays the same – increased supply precedes an increase in demand. But this time, corporations found their way into the world’s most profitable business. Remember this is only years before the healthcare industry decided that pain management is needed at every level of care, new laws allowed for direct- consumer advertising, and customers were literally demanding opium (pain medication).
Opium is grown in four places in the world today; Southwestern Asia (Golden Crescent), Southeastern Asia (Golden Triangle), Columbia, and Mexico. The majority of illegal heroin in the United States comes from the Western Hemisphere, but prices remain at an all-time low because the world’s supply has created competition. Lower prices will encourage more people to use and with the astronomically high profit-margins, the loss is minimal to the cartels – both legal and illegal.
The Business Plan
The 1997 North American Free Trade Act passed by the Clinton Administration also had substantial indirect consequences to the current epidemic. This act allowed free trade between Canada, U.S.A., and Mexico, which flooded the borders with traffic and customs agents were unable to stop the increased flow of illegal drugs.
While well-intended, this law led to an increase in black tar heroin in America and put the control of the supply in the hands of Mexican drug cartels. And while the Cold War ended in 1990, Afghanistan became the largest producer of opium, and Americans no longer had a reason to occupy the Golden Crescent – Until September 11, 2011, and the “War on Terror” was created.
The Taliban had controlled 90-percent of Afghanistan from 1996 to 2001, but was quickly eliminated following the terrorist attacks of 9/11/01. Since the fall of the Taliban, opium production has actually risen each year since American occupation.
The terrorist attacks also changed things back home. President Bush created the NSA and Homeland Security which put tighter restrictions on the Mexican border. This meant we cut off the largest supplier of illegal drugs in America (Mexico), but we already have established a new demand. With such large demand and our hands in the world’s new largest supplier of opium, a need surely will be met to feed addictions.
President Bush had the answer with the Medicare Prescription Drug Act of 2003. This act was a handout from the United States taxpayers to the Drug and Health Care Corporations of $800 billion. This bill gave pharmaceutical companies freedom to charge whatever they wish, healthcare as the middleman, and the consumer as a life-long customer (also called a drug-addict).
Now we have a need for drugs (literally addicted), the supply in Afghanistan, and cut off supply from the biggest competitors from Mexico, and free reign to the corporations (the same corporations that lobbied billions of dollars to congress to pass this bill).
The industry known as “health care,” does absolutely nothing to care about our health. The for-profit system is a business, just like any other major corporation, with intents on minimizing costs and increasing revenue.
And Now Comes the Sick Part…
Corporations are making huge profits by getting people addicted to drugs (pharmaceutical industry), by creating diseases to justify drugging them (psychiatry industry), and then denying them the help they need for this addiction we created (health insurance industry).
In sharing Susie’s story, it is clear that the sick ones are not those addicted to heroin, but those in offices deciding the fate of those in need.
Susie had completed residential treatment months earlier and had a chance to clear her mind and work on skills to avoid further harm. While working on building support, Susie had a relapse by injecting heroin over the weekend.
Heroin relapse is often fatal because after abstaining from using for a period of time, your tolerance significantly drops and your body can no longer handle the effects. Furthermore, heroin is at an all-time high as far as lethality. Back in the 1970s it was about 10-15 percent purity and now the numbers are closer to 70 percent pure heroin. Dealers have typically mixed alternative products in heroin to maintain greater quantities of their product, but with supplies and competition escalating, dealers need to provide higher quality for repeat business.
Susie survived the relapse but was in need of further treatment.
But her fate is handed off to a “clinical specialist” at the insurance company that lacks education, experience, or licensure. Instead, it is just a young kid in their mid 20’s that has been trained to “JUST SAY NO!”
Literally, they are told to deny claims. In the medical industry, a claim is referred to as a “medical loss.” Think about it; if you deny care, it saves the company money. If you save the company money, they have more profits.
How did such a corrupt system begin? President Nixon passed the HMO (Health Maintenance Organization) Act of 1973, which eventually gained many federal subsidies and virtually eliminated affordable individual health care plans.
In a meeting at the White House between President Nixon and John Erlichman (speaking for Edgar Kaiser) in promoting HMOs, Ehrlichman quotes Kaiser stating, “All the incentives are toward less medical care, because—the less care they give them, the more money they make.” – Mr. Ehrlichman quoting Edgar Kaiser to President Nixon on February 17, 1971
The Story of Susie…
Susie’s insurance company offered to cover four days of treatment following her relapse. The “specialist” performs a role of reverse-salesman in justifying reasons for denying coverage. They ask questions such as “Wasn’t she just in treatment?” “Where is she getting these drugs?”
After four days, the insurance provider comes back and says that since Susie is doing well she no longer needs residential services. They view the client as a number and a bottom line and have become desensitized to the word ‘heroin’ because the epidemic has normalized its use.
“This is too serious and I am terrified that if we do not authorize services, that we both might be attending a funeral,” said Susie’s counselor, “Actually, only one of us will, because papers and numbers don’t have funerals. But I’m dealing with a human life, unlike you.”
Two weeks later, Susie died from a heroin overdose.
United Health Group CEO Stephen Hemsley is paid a salary of 3.2 million dollars (with a total compensation package of $34 million) and owns a $10 million home in Wayzata, Minnesota. Every day in 2009 he earned $819, 363.10.
The best treatment center in Hemsley’s home state is Hazelden-Betty Ford Center. A 28-day residential treatment program at the world’s finest facility costs $30,000.
Hemsley’s hourly wage was around $102,741.68 in 2009. At this rate, if Mr. Hemsley were to not pay himself for 17 minutes of one day in 2009, he could have paid for full services at the world’s best treatment center for this kid for 28-days.
But let’s not single him out, the top ten health insurance companies CEO averaged a salary of $13 million per year, with their average worker making $35,000.
With all that money, imagine all the services and care people could receive, instead of increasing the wealth of one person? We could create an entire industry and call it “health care.”
About the Author
An avid historian, Irwin Ozborne (a pen-name) is a survivor of childhood abuse and torture over a period of 13 years, and a recovered alcoholic. As a mental health practitioner, today Irwin practices holistic care and incorporates eastern philosophy into his work with clients.
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