Cheers to health care initiative momentum. Jeers to politics as usual with drugmakers, lawmakers

County, health care chief forging ahead

Cheers to Manatee County’s growing momentum on a community health care initiative. One major step forward occurred in late September when the county hired a health care services manager, Joshua Barnett, to lead the initiative and collaborate with community stakeholders. Another materialized last November when the county established a Healthcare Advisory Board to offer recommendations on health care issues, particularly for the underserved, uninsured and working poor.

Barnett got to work quickly, floating new ideas to the advisory board. His first major proposal is the creation of four sub-groups among the 11 board members, each with a distinct mission for dealing with the community health care dilemmas. One group would tackle the 800-pound gorilla in the room — how to reduce the number of residents lacking health insurance, thus easing the financial burden on the medical community and the county budget.

Another is charged with reviewing the advisory board structure to figure out whether or not it is representative of the community. The third would mine the recent report by a consultant, Health Management Associates, for the best elements to follow or improve upon. The fourth will examine the county’s health care goals and the challenges inherent in each in order to develop ideas on lowering those hurdles.

Barnett carries a superior career and education history, as evidenced by a comment from Karen Windon, deputy county administrator, upon announcing his employment last month: “His background is behavioral health and his experience integrating primary care into that setting is exactly what we need in our community.”

Windon’s statement comes into sharper focus with these additional details of his background: management in public mental health, substance abuse and physical health treatment services in the private, public and nonprofit sectors.

Welcome, Mr. Barnett. Your mission is solving a problem nobody else could over almost a decade — perhaps starting with a deep 2008 analysis of the county’s health care system with the goal of identifying “a starting point from which to begin to address issues inherent in the system.” You’ll find that report gathering dust somewhere.

Here’s to you leading a fresh start.

Big Pharma, lawmakers, money and drug crackdown

Jeers to the political power of Big Pharma and the legislators who pocket the industry’s generous campaign contributions. The Associated Press and the Center for Public Integrity conducted an investigation and discovered drugmakers that manufacture opioid painkillers and allied advocacy organizations doled out more than $3.8 million over the past 10 years in campaign donations and lobbying.

During that time, Florida struggled to adopt curbs on pain management clinics known as “pill mills” — with pitched battles in the Legislature by a relentless group of lawmakers who threw up roadblocks to meaningful restrictions on bogus prescriptions for opioids such as Vicodin and Oxycodone. Pill mills — unregulated — would routinely write scripts and sell the controlled substances for cash, by the hundreds of pills.

Florida became the epicenter of the national drug abuse epidemic, and Manatee County was particularly hard hit. Prior to the state’s crackdown on pill mills via laws adopted in 2010 and 2011, Florida was awash in controlled substances. Just in one year, 2010, Oxycodone overdose deaths totaled 1,515 — more than four every day. Scripts for some 650 million Oxycodone pills were written in the state, amounting to more than 34 pills for every state resident, the analysis showed.

Big Pharma enjoyed huge profits and must have been aware such sales figures could not be medically justified. In 2010, drugmakers producing opioid painkillers and their allies funneled $500,000 to candidates — the second highest amount to the $705,000 in 2008, a boom year for pill mills.

Finally, in 2011, the state implemented a 2010 statute. The law’s centerpiece was the actual creation of a prescription drug monitoring program whereby physicians and pharmacists could check a patient’s medication history in order to flag abuse. That prescription database was authorized in 2009 but was not implemented. And not surprisingly, opposition to the database continued to the bitter end.

The crackdown included new criminal and administrative penalties, a ban on doctors from dispensing narcotics with exceptions, and other tough regulations. Florida’s lax laws were finally history. In 2014, Attorney General Pam Bondi declared Florida’s pill mill doctors were gone.

People often quote this catchphrase: Follow the money. While the state dragged its feet on a drug crackdown, pill makers profited handsomely and spread some of that money around to lawmakers. Quid pro quo?

Quote of the week

“We are overflowing. It doesn’t change. It’s still so many dogs and no place to put them. It is just unreal how many animals there (at the county shelter) that are unwanted.”

Lisa Williams, board member, Manatee County Animal Services Advisory Board, speaking Wednesday at a meeting where a mandatory spay and neuter ordinance was discussed.

This story was originally published October 28, 2016 at 4:07 PM with the headline "Cheers to health care initiative momentum. Jeers to politics as usual with drugmakers, lawmakers."