House Bill 241, introduced by Gilmanton Republican Rep. David Nagel, would require health insurers to cover alternatives to opioids for pain management.
As the opioid crisis spread across the United States, New Hampshire was one of the hardest-hit states. The National Institute on Drug Abuse reported 424 opioid-related overdose deaths in the state in 2017, the year the public health emergency was formally declared. That’s 34 deaths per 100,000 people, more than double the national average of 14.6, putting the Granite State among the top five most afflicted states.
One of the many complicated elements fueling the crisis, senators said in a bill intended at mitigating its effects, was the American medical system’s reluctance to manage pain with alternatives to prescription opioids like Purdue Pharma’s OxyContin. Those opioids were later discovered to be highly addictive, driving consumers to heavier, more hazardous substances.
House Bill 241, sponsored by Gilmanton Republican Rep. David Nagel, would compel health insurers to cover physical therapy, acupuncture, massage therapy, chiropractic care, and cognitive behavioral therapy as alternative pain therapies to opioids. The bill, which aims to provide alternatives to not only opioids but also other mainstream treatment choices such as surgery, was reviewed during a hearing Thursday in the House Commerce and Consumer Affairs Committee.
Nagel is a doctor who specializes in pain management and acupuncture, and he wrote a book titled “Needless Suffering: How Society Fails Those With Chronic Pain.”
“We are harming people with our inability to treat pain,” he stated at the hearing.
Nagel stated that many of the treatments contained in this law are inaccessible to patients, despite their effectiveness. For example, he stated that chiropractic care is the most cost-effective approach to managing back pain, whereas spinal surgery is the least expensive, even though so many patients seek treatment from spinal surgeons. Nagel compared his approach to Asian medicinal techniques, which are more “circular” and seek a broader range of therapy possibilities.
During the meeting, Rep. Lisa Post, a Lyndeborough Republican and committee member, lauded Nagel and detailed how his book and expertise helped her cope with the effects of a car accident without requiring significant surgery.
While he supported encouraging these alternative treatments, Rep. John Hunt, a Rindge Republican, objected to the measure’s requirement that insurers pay when doctors, he said, are not directing people to chiropractors or other providers specified in the law. The dilemma, he explained, was that he does not believe the government should override a doctor’s knowledge.
“The number one problem is everyone is going to that expensive surgery right off the bat,” Hunt informed me.
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