MA Advocates Support Adding Medical Marijuana to Obamacare

Monday, May 19, 2014

Jack Andrade, GoLocal Reporter

Local advocates for medical marijuana believe Obamacare and other healthcare plans should cover medicinal marijuana as well as pharmaceutical drugs, adding another layer to the hot button debates.

John Simpson, owner the Doggett & Simpson cannabis nutrient company, strongly believes medical marijuana should be covered by health insurance for those who need it.

“If we agree that it confers medical benefits, which I certainly believe strongly that it does, and I think that that’s beyond dispute, I don’t see how you justify denying it insurance coverage.”

The Prescription Debate

For prescription drugs, a doctor writes out a prescription and the patient presents it to the pharmacy in exchange for the medicine. Medical marijuana patients have a recommendation card that is presented to caregivers or dispensaries. Kevin Sabet, Ph.D. and co-founder of project SAM (Smart Approaches to Marijuana) says the processes are not similar enough to warrant insurance coverage for medical marijuana.

“The process for getting a medical recommendation is very different from an actual prescription,” says Sabet. “In the latter, a bona fide physician must write a prescription which gets entered into a database. That prescription must be used at an actual pharmacy and dispensed by a pharmacist. A medical card is received upon a ‘recommendation’ which, depending on the state, does not have to be issued by the patient's actual physician. Also the recommendation is then used at marijuana stores-- most of which are not run by medical personnel.”

“Opponents are going to say, this isn’t a prescription, it’s just a recommendation,” said Worcester native and marijuana advocate Wayne Reiss. [They'll say] “Your doctor can recommend that you play basketball, but you can’t go to the YMCA to play basketball and have your healthcare cover that.”

Reiss doesn’t see the prescription process as grounds to deny coverage, but Simpson believes the processes are similar enough that a coverage plan could and should be worked out.

“In my opinion they’re certainly close enough, and I don’t see how you can deny it insurance coverage,” said Simpson. “It does carry with it some unique challenges but I don’t think the response to that challenge is to throw up your hands and say ‘well we won’t have it covered then.’”

The Art of Medicine

According to Reiss, medicating patients is an art form, not an exact science.

“The courses that are taught in medical school are taught predominantly geared towards pharmaceutical drugs, like ‘here’s the problem, how do we solve the problem,’” said Reiss. “When you use herbs as medicine, that’s not really an exact science, that’s an art.”

Reiss points to morphine and penicillin as drugs accepted as medicine based on anecdotal evidence, not FDA approval. He believes there is enough anecdotal evidence to show medical marijuana does work for some patients.

Treating the patient and not the disease is key for Reiss.

“When you treat a person with cancer, you aren’t treating the cancer, you’re treating a person, and that’s an art,” he said. “I think that medical schools have sort of gotten away from the art of healing, and that’s a shame.”

Issues with Smoking as Medicine

Experts against adding medical marijuana to Obamacare argue that smoking is not an acceptable means of medicating an individual.

“I think the chances of getting a smoked joint covered by Obamacare is zip,” said Sabet. “Joints cannot be dosed, and smoking is not an accepted medication delivery system.”

Future Insurance Ramifications

Sabet is willing to consider the medical benefits marijuana provides, but says insurance should never cover smoking and other unapproved medical practices.

“Medicines derived from marijuana and delivered in non-smoked forms may indeed at some point be covered by insurance exchanges, and no one has a problem with that,” said Sabet. “The bottom line is that only approved medicines - derived from marijuana or not - should be covered by insurance.”

Simpson disagrees, arguing that if medical marijuana is the best option available it needs to be covered.

“I think it’s a bit of a litmus test,” said Simpson. “I think if society is sincere and accepting that this does offer significant medical benefits above and beyond what’s even available through industrial pharmaceuticals for some conditions, then I don’t see how you can deny it insurance coverage.”

According to Simpson, a secondary benefit of insurance coverage is that doctors would be more inclined to advise patients on whether or not to use marijuana medicinally.

“I think if it’s being covered by insurance then Doctors would be inclined to take it very seriously as something that is a medical option, but that they shouldn’t recommend more lightly than they would prescribe another drug,” said Simpson.

Reiss agrees that regulation and responsibility are important, but people have a right to access the best possible healthcare.

“People should have the right to choose what medicine works for them, Reiss states. “What we should do is regulate things as best we can, and provide people with the best information to help them make informed decisions.”

Editor's note: A previous version of this story stated that Reiss "doesn't see the prescription process as grounds for coverage" but should have said Reiss "doesn't see the process as grounds to deny coverage." Any implication that Reiss does not believe medical marijuana should be covered by Obamacare is false. We regret and apologize for the error in the author's language.