Common-sense pain treatment

Eleven years ago, my life changed dramatically. I was at the pinnacle of my 21-year career as an attorney, consultant, and chief of staff for members of the California State Assembly and the U.S. House of Representatives. Then, one fateful day, I tripped over a large bin that was mistakenly placed in a high-traffic area in the office. That incident began my years-long journey as someone living with chronic pain.

Because my injury happened at work, I was required to seek treatment from workers’ compensation physicians and was given medications that failed to alleviate my symptoms. I was even told that there were no pain-relief alternatives, and I just needed to “live with it.”

Excruciating pain was constant during those years. I began to suffer from depression, was forced to retire early and had no income, and personal relationships began to suffer. Also constant were my battles with my insurer. In California, some insurers refuse to cover doctor-prescribed pain treatments. Instead, patients must try (and fail) on up to five older, less-effective treatments before the insurer will cover what the doctor initially prescribed.

Insurer practices go by names like “step therapy” or “fail-first,” and insurers implement them in the name of cost containment. Cost containment is critical, but these policies go too far and often cause patients to go for weeks, months, or even years without effective treatment.

In 2007, I had another setback after an automobile accident. Fortunately, at that time, I sought independent treatment, and was placed in a chronic pain management program that helped get my life back on track.

A small measure of relief may be on the way for other Californians in pain. Assemblyman Jared Huffman (D-San Rafael) has introduced common-sense patient-protection legislation. Assembly Bill 369 prevents insurers from requiring that patients try and fail on more than two pain medications before allowing the patient access to the treatment originally prescribed.

Ultimately, delay or denial policies may make economic sense to insurers. However, they can cause unnecessary pain, depression and economic loss to Californians like me. Common-sense middle ground must be found to help California pain patients. Assemblyman Huffman’s bill is a good first step.