Tag: Matt McCord

How Using Opioids for Acute Pain is Like Burning Coal for Energy

Apr 21, 2025

By MATT McCORD

Using opioids to treat acute pain is a lot like burning coal to power our homes. Both are legacy solutions from an earlier era. Both were once celebrated as breakthroughs. And both have since proven to be dirty, dangerous, and incredibly costly to clean up. Despite this, we continue to rely on them, even as safer, smarter alternatives sit right in front of us.

Coal fueled the Industrial Revolution—but it did so at a steep price: polluted air, poisoned water, caused respiratory illness, and climate instability. It was never a clean solution, just a convenient one. Similarly, opioids became the go-to solution for pain not because they were ideal, but because they were easy. They blunt pain quickly, require no special skill to administer, and were aggressively marketed to physicians as safe and effective. We now know the truth: opioids for acute pain can ignite a chain reaction that leads to dependence, chronic pain, disability, and even death.

Short-Term Relief, Long-Term Consequences

The similarities run deep. Coal gives you power today but saddles society with pollution and disease tomorrow. Opioids offer pain relief in the moment but often leave patients worse off in the long run. In both cases, what’s convenient in the short term creates massive long-term externalities—not for the industries that profit, but for the workers, families, and communities left to clean up the mess.

Systemic Pollution

Coal pollution clogs lungs and chokes rivers. Opioids pollute something more intimate—the brain’s natural ability to regulate pain.

Acute use of opioids disrupts normal pain modulation, leading to a phenomenon called opioid-induced hyperalgesia—a worsening sensitivity to pain. It’s like installing a furnace that makes your house colder over time, requiring more fuel just to maintain baseline comfort. That’s the trap many patients fall into after routine surgery or injury.

Hidden Costs and Broken Systems

Coal seems cheap—until you calculate the health consequences, environmental damage, and regulatory burden. The same is true for opioids. The prescription may be covered by insurance, but the downstream effects—addiction treatment, emergency room visits, lost productivity, broken families, foster care placements, criminal justice costs, and overdose deaths—are paid for by the rest of us. And the price is staggering. Like coal, opioids externalize their costs, masking the true price we all pay.

Entrenched Interests and Resistance to Change

Just as coal was propped up by powerful lobbies and outdated infrastructure, opioids have persisted because of habit, inertia, and industry influence. For decades, pharmaceutical companies promoted opioids with junk science and aggressive marketing. Today, the pharmaceutical industry continues to shape public perception—not just through lobbying, but through the media itself. Pharmaceutical companies are among the largest advertisers on television, particularly during news programming. This significant advertising presence may influence media narratives, potentially downplaying the role of prescription opioids in the opioid crisis.

As a result, the public is often fed a new narrative: that fentanyl is the problem, not prescription opioids.

The Return of American Manufacturing Demands a Chief Health & Benefits Officer (CHBO) to Fix Benefits Procurement

Mar 26, 2025

By MATT McCORD

American manufacturing is making a comeback. Driven by tariffs, supply chain instability, and shifting economic priorities, companies are reshoring production—reinvesting in U.S. labor and operations.

But there’s one major obstacle still standing in the way: the crushing cost of American healthcare.

For decades, U.S. employers have overpaid for healthcare without improving outcomes. Ballooning insurance premiums bloated administrative costs, and an opaque, middleman-driven system have left businesses with the highest healthcare costs in the world—twice as much as top global competitors.

If manufacturing is returning, shouldn’t we be demanding a more efficient and productive healthcare model to support it? The same industries that once offshored to escape labor costs must now confront the reality that the old way of buying healthcare is broken.

The Consolidated Appropriations Act (CAA) & The Growing Fiduciary Risk

The game has changed. The Consolidated Appropriations Act (CAA) of 2021 imposes strict new fiduciary requirements on employers that sponsor health plans. Companies can no longer blindly trust big insurance carriers or PBMs to act in their best interest.

If businesses fail to properly manage their healthcare spend, they are now liable for excessive costs, lack of transparency, and conflicts of interest.

🔴 This isn’t just theoretical—JP Morgan Chase is now facing a class-action lawsuit over how it managed its employee health plan, with board members named as defendants.

Employers have always scrutinized office supply costs, travel budgets, and vendor contracts—yet they’ve handed over healthcare procurement to third-party insurers with zero accountability.

Now, that lack of oversight is a legal risk.

Why Employers Need a Chief Health & Benefits Officer (CHBO)

Every major business function has an executive leader ensuring strategy, efficiency, and accountability:

CFOs manage financial health with precision.
COOs streamline operations for maximum productivity.
CIOs leverage technology to drive innovation.

So why do we continue to let third-party insurers and middlemen dictate healthcare purchasing without a dedicated executive overseeing the strategy?

Mark Cuban recently called for a new C-suite role: the Healthcare CEO (HCEO). A more appropriate and less confusing term may be the Chief Health & Benefits Officer (CHBO). This leader would act as a fiduciary to the company, ensuring that its health benefits strategy delivers better outcomes at lower costs—just like a CFO does with financial oversight.

This isn’t a job for HR.

How Routine Medical Care Fuels America’s Opioid Crisis

Mar 17, 2025

By MATT McCORD

When most Americans undergo surgery, they expect to recover quickly and return to their normal lives. Few realize that something as routine as a shoulder surgery, a hernia repair, or a mastectomy can mark the beginning of a life-altering opioid addiction. This often-overlooked connection between routine medical care and opioid dependence demands urgent attention.

How Physicians and Hospitals Sustain the Opioid Epidemic

For decades, the pharmaceutical industry has shaped medical education, ingraining the belief that opioids are the best first-line treatment for acute pain. As a result, American physicians prescribe opioids at dramatically higher rates than their counterparts in other countries. A recent study in Annals of Surgery found that after three common surgeries, 91% of U.S. patients were prescribed opioids, compared to just 5% of the global patients.

Hospitals and health systems have also played a significant role in perpetuating opioid dependence. Opioids have long been a convenient and cost-effective solution for acute pain management, readily available and inexpensive to administer. However, the financial incentives for hospitals extend far beyond the initial prescription. The short-term complications of opioid use—such as nausea, constipation, urinary retention, and hyperalgesia—require additional treatments, increasing hospital revenue. Long-term complications, including dependence, overdose, and addiction, further drive profitability through repeat admissions, extended care, and emergency visits. In effect, hospitals and health systems have become financially reliant on opioid-based care, benefiting from both the immediate and prolonged consequences of opioid prescribing.

A study from the University of Michigan/IBM Watson revealed that a single opioid prescription after elective surgery increased healthcare costs by an average of $5,680 per patient per year across all payer types, including Medicare, Medicaid, and commercial insurance. This widespread cost increase affects insurance premiums, employer healthcare spending, and state and federal budgets. Notably, this estimate does not even account for the long-term costs of addiction treatment, which can be 2-16X that cost per patient per year.

The Devastating Impact of Routine Opioid Prescriptions

Each year, over 60 million surgeries are performed in the U.S., leading to the prescription of 45 million new opioid prescriptions per year. But the real crisis lies in what happens next: nearly 10% of all surgical patients remain on opioids long after their recovery should be complete. That means 2-4 million Americans every year are still using opioids beyond 90 days post-surgery.

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