In all of the debate about the healthcare system–which is actually a debate about paying for healthcare–what goes missing is, well, healthcare. That is, does the healthcare system increase or decrease lifespan, quality of life, and so on. Which brings us to this story about insurers and opioids (boldface mine):

At a time when the United States is in the grip of an opioid epidemic, many insurers are limiting access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications.

The reason, experts say: Opioid drugs are generally cheap while safer alternatives are often more expensive….

ProPublica and The New York Times analyzed Medicare prescription drug plans covering 35.7 million people in the second quarter of this year. Only one-third of the people covered, for example, had any access to Butrans, a painkilling skin patch that contains a less-risky opioid, buprenorphine. And every drug plan that covered lidocaine patches, which are not addictive but cost more than other generic pain drugs, required that patients get prior approval for them.

In contrast, almost every plan covered common opioids and very few required any prior approval.

The insurers have also erected more hurdles to approving addiction treatments than for the addictive substances themselves, the analysis found.

One advantage of a national system, regardless of the payment mechanism, is that it’s much easier to track these sorts of data, meaning we can react earlier to emerging public health problems–which is what opioid abuse was less than a decade ago. And it’s not just drug addiction: other problems, such as antibiotic resistance and infection control, would benefit greatly from a national healthcare system. The economics are important, but the ultimate goal is to improve human health. It’s clear our current system fails to do that.