ABSTRACT
The legislative efforts resulting in the Affordable Care Act (ACA) serve to highlight the power and influence the health care industry has over this sector. The chapter provides a brief examination of the Medicare Prescription Drug Improvement Act of 2003. It then notes how the Obama administration ultimately pursued a plan modeled on that devised in Massachusetts, under then Republican Governor Mitt Romney, which achieved virtually universal coverage but made no serious efforts to control costs. In the case of the ACA, the plan that emerged is, in fact, more complex and bureaucratic than Medicare, but has ensured that taxpayer dollars would continue to flow to the private entities that crave them. The chapter then turns to the ongoing public health crisis associated with the opioid epidemic in the US. Here, we examine the role of a major pharmaceutical producer in aggressively marketing a prescription opioid over many years in the face of evidence about its addictive qualities. It also examines the role of drug and medical supply distributors, among which are massive corporations, in hampering the government’s capacity to curtail the crisis by enlisting former Drug Enforcement Agency employees and key politicians in the effort.
