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December 11, 2018
David W. Johnson
Economics Outcomes

How to Create Pro-Market Healthcare Reform in an Opioid Crisis

Over 200,000 Americans have died since 2000 due to opioid overdoses.[1] That’s equivalent to all of Salt Lake City[2] disappearing from our country. The epidemic is destroying communities throughout America, thanks to the recent passage of the Drug Enforcement Act led by the lobbying efforts of Big Pharma and their Congressional allies. McKesson, Cardinal Health and AmerisourceBergen distribute 85% of the nation’s drugs and have all paid fines for improperly distributing opioids. Crony capitalism is perpetuating the cycle of powerful businesses corrupting the democratic process at the expense of the American people.

To provide better value to Americans, our healthcare industry must become more pro-market and less pro-business. Pro-market promotes value creation in a fair playing field for businesses. Pro-business protects the interests of large businesses that minimize competition and increase regulation in their favor. Market-driven healthcare reform requires effective regulation that protects societal interests and also encourages innovation.



Big Pharma exploits the addictions of susceptible patients with oxycodone, fentanyl, hydrocodone and other opioid-based drugs. Why else would a pharmaceutical distributor send over 9 million pills to a West Virginia town that has less than one thousand people in population? Senator McCaskill noted these pills were diverted to the black market and Congress had not properly managed Big Pharma distributions.2

In 2006, the Drug Enforcement Agency (DEA) deepened their investigation into the pharmaceutical industry. Since then, the DEA fined a pharmaceutical company and 13 of its distributors for $425 million for suspicious and dangerous distributions. Big Pharma then hired 56 former DEA and Justice Department officials to lobby for the Drug Enforcement Act and spent $106 million on the act between 2014 – 2016. This act was signed into law by President Obama and made it practically impossible for the DEA to justify immediate suspension of suspicious orders.



Successful healthcare organizations should not have to get patients addicted to pain killers or manipulate the regulating authorities of congress to grow their bottom line. Organizations that provide quality care and better outcomes for patients will reap the most loyalty and revenue from consumers. Our nation cannot sustain crony capitalism and its deathly effects.

Societies need to be protected from these deadly addictions. In just one week, the Cincinnati Enquirer reported the following statistics from their documentary, “Seven Days of Heroin: This is What an Epidemic Looks Like:”[3]

  • 18 deaths
  • 180+ overdoses
  • 200+ heroin incarcerations
  • 15 heroin-addicted babies born

Americans need regulations that protect society and encourages innovation. Current, past and future generations are severely affected by the manipulations of Big Pharma and their Congressional allies. Consumers need healthcare organizations that care. If crony capitalism persists, then Big Pharma will continue to manipulate the markets and harm communities. If we preserve democracy and competitive markets, then healthcare companies will win by producing convenient services and quality care.

To read more on this topic, click here to read the full 4sight Health Market Corner Commentary.


[1] https://www.wvgazettemail.com/news/health/drug-firms-poured-m-painkillers-into-wv-amid-rise-of/article_78963590-b050-11e7-8186-f7e8c8a1b804.html

[2] http://worldpopulationreview.com/us-cities/

3 https://www.npr.org/2017/10/17/558267052/senate-democrat-calls-on-trump-to-withdraw-tom-marinos-nomination

4 https://www.cincinnati.com/pages/interactives/seven-days-of-heroin-epidemic-cincinnati/

About the Author

David W. Johnson

David Johnson is the CEO of 4sight Health, an advisory company working at the intersection of healthcare strategy, economics, innovation. Johnson is a healthcare thought leader, keynote speaker, and strategic advisor to organizations busting the status-quo to reform our healthcare system. He is the author of Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare, and his second book, The Customer Revolution in Healthcare: Delivering Kinder, Smarter, Affordable Care for All (McGraw-Hill 2019). As a speaker, Dave plays the role of rebel, challenger, industry historian, investor and company evaluator to push audiences forward. (Watch bio video.) Johnson applies his 25+ years of investment banking in healthcare to identify ways the healthcare industry must change to deliver better care. He received a Masters in Public Policy from Harvard Kennedy School, an English degree from Colgate University, and served in the African Peace Corp service. Join over 10k+ healthcare executives who read our weekly insights and commentary on www.4sighthealth.com. His third book, Less Healthcare, More Health: The Prescription for a Happier, More Equitable and Productive America, will publish in 2024.

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