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Comment by iaw | Hacker News Reader

Very good write-up from Esquire, I'm thoroughly impressed with the article.

That said, my visceral emotional response is strongly negative especially when reading the following paragraph:

>In May, a dozen lawmakers in Congress, inspired by the L.A. Times investigation, sent a bipartisan letter to the World Health Organization warning that Sackler-owned companies were preparing to flood foreign countries with legal narcotics. “Purdue began the opioid crisis that has devastated American communities,” the letter reads. “Today, Mundipharma is using many of the same deceptive and reckless practices to sell OxyContin abroad.” Significantly, the letter calls out the Sackler family by name, leaving no room for the public to wonder about the identities of the people who stood behind Mundipharma.

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In the Massachusetts episode of Parts Unknown, Bourdain talks to a general physician who explains how patients who were administered OxyContin for routine procedures & injuries quickly developed a habit for the drug and when they couldn't find it post-treatment moved to illegal variants like Heroin and now Fentanyl.[1][2]

Bourdain travels to Franklin County to explore the heroin epidemic that’s spreading throughout this and other New England towns.[1]

Dr. Ruth Potee of Greenfield, Massachusetts talks about how they were taught in their residency that their ER / Hospital performance was tied to their pain scores and the generous administration of pain medication to patients.[1][2]

Purdue Pharmaceuticals promotion from 1996 can also be seen.

[1] Video - Parts Unknown - Massachusetts

https://archive.org/details/AnthonyBourdainPartsUnknownMassa...

22:16 Purdue Pharmaceuticals Promotion from 1996

25:10 Dr. Ruth Potee of Greenfield, Massachusetts

[2] Transcript - Parts Unknown - Massachusetts -- CNN

http://transcripts.cnn.com/TRANSCRIPTS/1502/20/abpu.01.html

Edit: Another link to the same Parts Unknown - Massachusetts video

http://www.dailymotion.com/video/x58d4ci

> ER / Hospital performance was tied to their pain scores and the generous administration of pain medication to patients...

Trace back how these performance metrics were chosen, look in history if there was any advocacy or studies funded by Sackler-controlled/-influenced parties to tilt the selection of performance measurements towards subjective pain "scoring". It would be interesting to find out if Arthur's insight of nebulous broad applications was generalized to pushing for these kinds of metrics.

After reading how Epipen configured a de facto monopoly, I've wondered where else this kind of corporate behavior shows up within our economic landscape. None of it breaks any laws, but I have to wonder if anyone involved regrets the consequences engendered.

That more about managed care and managing ER outcomes like help desk tickets. The old fee for service models are going away as costs increase.

Medicare and Medicaid HMOs pay for “results”, not visits. So you need to either get admitted or get the hell out and don’t come back to the ERir they lose revenue.

And to top it off, they've even purchased/negotiated prosecutorial immunity:

The Sacklers, though, will likely emerge untouched: Because of a sweeping non-prosecution agreement negotiated during the 2007 settlement, most new criminal litigation against Purdue can only address activity that occurred after that date. Neither Richard nor any other family members have occupied an executive position at the company since 2003.

Brilliant. Who says lawyers aren't worth the money?

which part bothers you?

There's a hypocrisy intrinsic in claiming that OxyContin is too dangerously addictive to go generic but still pushing it in under-saturated markets. It's the disregard of human life/experience innate in this line of behavior.

I don't think you cited the portion of the article you intended to. Your whole comment is confusing.

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