During Lent, from Ash Wednesday to Easter, Christians focus on their relationship with God. Protestants, once skeptical, now embrace Lent. Scott Hubbard advocates embracing it as a path to refocus and encounter Jesus. Lent is seen as an opportunity for spiritual growth and reflection, to gain more than we give up.
During Lent, some people commit to fasting (refraining) from certain foods or drinks or giving up certain pleasurable activities or habits during the 40 days before Easter.
Some people choose to do something, like performing a service to others, doing a meditative or spiritual activity, or some repetitive action to remind them of the season.
In this article, Scott Hubbard explains how Protestants first rejected, but now embrace Lent and offers resources on observing Lent in a new way.
Consider the days ahead as an opportunity — as one more path you might walk to focus your scattered attention, warm your heart’s affections, and meet the risen Jesus afresh.
What if you fasted regret? What if your friends fasted comparison? What if your generation fasted escapism? What if your community fasted spectatorship? Trigger a spiritual revolution with this daily devotional for Lent.
Decrease life’s unnecessary details and increase your relationship with the Lord so you can live in awe of Christ’s resurrection!
40 Days of Decrease is a guide for those hungering for a fresh Lenten/Easter experience. Dr. Alicia Britt Chole guides you through a study of Jesus’ uncommon and uncomfortable call to abandon the world’s illusions, embrace His kingdom’s realities, and journey cross-ward and beyond.
I have used this devotional from Alicia Britt Chole. Using this affiliate link to the paperback or Kindle versions helps support this blog, thanks for considering.
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Dress yourselves in burlap and sit among the ashes. Mourn and weep bitterly..
Jeremiah 6:26, NLT
Try Dwell for Lent
Many people find using their phones a convenient way to read and meditate on the Bible. And it’s easy to do so with the Dwell Bible App.
With Dwell you can listen to and read the Bible and special devotional offerings for Advent, Lent, and throughout the year.
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Beyond Fasting
If we want to make the most of this annual opportunity (Lent), we’ll do more than just give something up.
We’ll silence ourselves before the Sovereign who became a servant. We’ll fasten our eyes upon him as he teaches and heals and smiles and weeps — the only upright man in a world of cracked and curved impostors
Scott Hubbard
Use these links to share the heart of health wherever you connect.
I’m glad to learn that states are mandating insurance coverage for non-opioid pain medications. Advocates push for laws that eliminate higher copayments for non-opioids. Despite challenges, bipartisan support is growing, driven by healthcare concerns regarding opioid dependence and addiction.
This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.
Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.
Pain Treatment: A Problem for Doctors and Patients
When I was practicing medicine, pain was one of the most difficult problems to manage. I had to balance the need to relieve a person’s pain while not creating dependence or addiction.
Sometimes patients came to me already on chronic opioids for pain. I had to decide whether to continue them or change the person to another treatment, which can be hard to do. Sometimes patients came to me requesting “something” for pain. Only by checking the state pharmacy database did I learn they were already receiving prescriptions for opiates from other physicians, sometimes several.
In my long medical career, there have been few non opiate alternatives for severe pain. So I am pleased to learn of a new drug which is exactly that. Unfortunately, its use may be limited due to cost. This article explains how states are trying to circumvent that problem.
(For the purpose of this article, consider the terms narcotic, opiate, and opioid as referring to the same type of drug.)
(edited for readability and clarity, no change to content)
More states are requiring their Medicaid programs and health insurance companies to cover non-opioid pain medications as an alternative to opioids, which can be cheaper for insurers but also more addictive for patients.
Advocates, providers, medical associations, and state lawmakers are pushing for parity in coverage. That means prohibiting insurers from charging higher copayments for non-opioids than they do for opioids, and barring them from requiring prior authorization or step therapy — mandating that patients try other medications first — before they will cover non-opioid drugs.
At least eight states have enacted such laws: Arkansas, Illinois, Louisiana, Maine, Massachusetts, Oklahoma, Oregon, and Tennessee. In states that are still considering legislation, the efforts have been bipartisan, pushed by lawmakers in some Democratic-controlled states, Colorado and New York, and some Republican-leaning states, Kentucky and Missouri.
The issue has gained momentum in recent years, as leading medical associations such as the American Society of Regional Anesthesia and Pain Medicine have urged providers not to prescribe opioids as the first-line treatment for pain.
Meanwhile, bipartisan legislation introduced in Congress last year aims to increase Medicaid Part D enrollees’ access to non-opioid pain medications. It’s been referred to a committee.
Dr. Patrick Giam, president of the American Society of Anesthesiologists, said the organization “believes it is important that insurance plans make non-opioid therapies as accessible to patients as opioid-based therapies.”
drugs to treat pain
The U.S. Food and Drug Administration has encouraged non-opioid pain relief alternatives.
acetaminophen, such as Tylenol and other brands, and
other medications.
(affiliate links)
Opioids include
oxycodone,
codeine,
morphine and
fentanyl.
suzetrigine-Journavx
Last year, the agency approved a new drug called suzetrigine, under the brand name Journavx, the first non-opioid pain relief medication in a new class of analgesic drugs. The drug, which is available in tablets, can be prescribed for acute pain after surgery or injury. Vertex Pharmaceuticals, the manufacturer, is one of the funders of Voices for Non-Opioid Choices, which has been lobbying for the bills.
In Missouri, where GOP-sponsored legislation would prohibit insurance companies from denying coverage of a prescribed non-opioid or requiring a higher copayment for a non-opioid, the Missouri Insurance Coalition has argued that the measure would increase health care costs and effectively create “a monopoly” for Journavx. Each tablet can cost around $15 per tablet out-of-pocket. But lawmakers pointed to non-opioid alternatives.
Why non-opioids often cost more
Newer non-opioid drugs entering the market are more expensive than opioids because there isn’t yet a generic alternative, explained Sterling Elliott, an Illinois clinical pharmacist and lecturer at Northwestern University’s Feinberg School of Medicine and a board member of Voices for Non-Opioid Choices.
Generic opioids are amongst the cheapest medications that you’ll find flowing through the American pharmaceutical supply,
Sterling Elliott, clinical pharmacist
“The price is so high for a lot of things because the price for generic opioids is so low. Generic opioids are amongst the cheapest medications that you’ll find flowing through the American pharmaceutical supply,” Elliott said. “When you get a new entrant into the pain market, the marketplace factors are set up to drive the price up.”
Elliott added that some insurance plans don’t cover prescription-strength NSAIDs such as ibuprofen because they’d rather people pay out-of-pocket for lower strength, over-the-counter versions of those drugs.
In New York, Democratic Assembly member Phil Steck, the cosponsor of a bipartisan bill that hasn’t received a hearing, said challenging the insurance companies isn’t easy.
“You’re trying to tell insurers what to do,” Steck said. “Those are usually difficult undertakings. … Our experience is that the [legislature’s] insurance committee is very difficult to deal with, and so it hasn’t been pursued as much as we would like.”
Coverage of non-opioids can vary widely across insurance plans, explained clinical pharmacist Emma Murter, who co-chairs the advocacy committee of the Society of Pain and Palliative Care Pharmacists.
“There are so many [non-opioid] medications that can be used for chronic pain,” Murter said. “It isn’t gut-instinct obvious, what is and isn’t covered. It’s very Wild West, chaotic.”
When it comes to filling prescriptions, Murter said, she often has to “fight and appeal for some of these non-opioid therapies” with insurance companies.
Dima Qato, associate professor of clinical pharmacy at the University of Southern California, said non-opioid pain prescription meds are less common on insurance companies’ “preferred” drug lists. Because insurers may favor the less expensive opioids, that can result in higher copayments or consumers paying more out-of-pocket.
That was the case for Chris Fox, the Washington lobbyist who serves as executive director of Voices for Non-Opioid Choices. Fox has traveled to state capitals around the country to lobby for the bills. Recently, he had a personal experience with pain medications following oral surgery.
“For everything but the non-opioid, my out-of-pocket expectation was $0,” he said. He was charged $30 out-of-pocket for the non-opioid.
His oral surgeon wasn’t familiar with the availability of the new first-in-class non-opioid suzetrigine, Fox added. When he asked the doctor for a prescription for it, the surgeon wrote it but also prescribed an opioid along with an antibiotic.
“He prescribed me hydrocodone to go along with it, just in case, because he wasn’t as familiar with [suzetrigine],” Fox said.
Preventing addiction
As he spoke with Stateline by phone, Fox was driving to the local sheriff’s office to drop off the hydrocodone, which he didn’t take following his surgery.
“We’ve neglected the opportunity, I would say, to prevent opioid addiction where we can, which is in those patients that will develop a newly persistent opioid use pattern following exposure to an opioid that they get for medical reason,” Fox said.
Although opioid overdose deaths have declined, the drugs still kill about 200 Americans a day.
Health care professionals at hospitals also run into issues with lower reimbursement rates for some non-opioids.
Dr. Joseph Smith, an anesthesiologist at a Virginia surgical center who has practiced for three decades, pointed to a nerve-block pain pump as an example. Administering a brand-name version of the drug could cost up to $400 for all the equipment, he said. Smith, like Elliott, sits on the board of Voices for Non-Opioid Choices.
“So the hospital is like, ‘Well, I can spend $400 or I can spend 25 cents on a narcotic pill,’” Smith said.
Smith treats many young teen athletes with sports injuries. Research has shown post-surgery narcotic use can increase risk of addiction.
“My goal when I get a 14-year-old or 15-year-old in here is to never have them try a narcotic, never have them exposed to narcotics,” he said.
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Oklahoma Voice, and is supported by grants and a coalition of donors as a 501c(3) public charity.
It is shared here under a Creative Commons License.
Tolerance vs. Dependence vs. Addiction
Long-term use of prescription opioids, even as prescribed by a doctor, can cause some people to develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects.
Drug dependence occurs with repeated use, causing the neurons to adapt so they only function normally in the presence of the drug. The absence of the drug causes several physiological reactions, ranging from mild in the case of caffeine, to potentially life threatening, such as with heroin. Some chronic pain patients are dependent on opioids and require medical support to stop taking the drug.
Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and long-lasting changes in the brain. The changes can result in harmful behaviors by those who misuse drugs, whether prescription or illicit drugs.
While the initial choice to use a drug is often voluntary, the powerful effects of addiction makes it very hard to stop, even if someone wants to.
When drugs or alcohol are used so often that they have significant negative effects on your life, this is called a substance use disorder.
It causes intense cravings for alcohol or drugs, and can include:
Using illegal drugs like heroin or cocaine, or excessive alcohol drinking.
Using prescription drugs in ways other than prescribed, or using someone else’s prescription.
Using drugs repeatedly changes the brain, including the parts that help exert self-control. That’s why someone may not be able to stop using drugs, even if they know the drug is causing harm, or want to stop.
If you live outside the United States, contact your local source of medical care or search online for substance use treatment in your country.
Exploring the HEART of Health
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In this post I talk about my recent elective surgery and the shockingly high six-figure hospital bill. I offer a KFF Health News article detailing various patients’ exorbitant medical costs, emphasizing the importance of understanding medical bills, insurance coverage limitations, and potential avenues for reducing charges.
This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.
Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.
My Hospital Surgery Bill
Recently, I underwent an elective surgery to treat a painful but not life-threatening condition. It’s been a long time since I needed any type of surgery.
I received a message from the hospital about the projected cost of my procedure and one-night hospital stay. My husband has been in the hospital a few times over the past few years, so I knew to expect a large number. But I still gasped when I saw the 6-figure number following the dollar sign.
Now this is a non-life-saving, one-and-a-half-hour surgery, with a one-night stay in the hospital (sometimes a same-day surgery) that will “cost” my insurance companies and me over 100K! The only thought in my mind was “I’m so glad I have good insurance coverage.”
Of course, that astronomical number is nowhere close to what the insurance will actually pay, but that’s another issue. (see number 7 below) . But it caused me to notice this article from KFF Health News and pass it along to you.
Insured and uninsured. Job-based and government-funded. Comprehensive and short-term. Part of a sharing ministry. So many people with different health insurance situations asked the same questions:
Why do I owe so much? And how am I going to afford it?
As millions of Americans grapple with the rising cost of health insurance next year, the “Bill of the Month” series is approaching its eighth anniversary. Our nationwide team of health reporters has analyzed almost $7 million in medical charges, more than $350,000 of that this year.
Of this year’s 12 featured patients, five had their bills mostly or fully forgiven soon after we contacted the provider and insurer for comment.
Our mission, though, is to empower every patient with the information needed to understand, manage, and — if push comes to shove — fight their own medical bills. Here are our 10 takeaways from 2025.
1. Most insurance coverage doesn’t start immediately. Many new plans come with waiting periods, so it’s important to maintain continuous coverage until the new plan kicks in.
One exception: If you lose your job-based coverage, you have 60 days to opt into a COBRA policy. Once you pay, the coverage applies retroactively, even for care received while you were temporarily uninsured.
2. Check out your coverage before you check in. Some plans come with unexpected restrictions, potentially affecting coverage for care ranging from contraception to immunizations and cancer screenings.
Call your insurer — or, for job-based insurance, your human resources department or retiree benefits office — and ask whether there are exclusions for the care you need. Ask specifically about per-day or per-policy-period caps, and what you can expect to owe out-of-pocket.
3. “Covered” does not mean insurance will pay, let alone at in-network rates. Carefully read the fine print on network gap exceptions, prior authorizations, and other insurance approvals. The terms may be limited to certain doctors, services, and dates.
4. Get a cost estimate in writing for nonemergency procedures. If you object to the price, negotiate before undergoing care. And if you’re uninsured and receive a bill that’s $400 or more than the estimate, the federal Centers for Medicare & Medicaid Services has a formal dispute process.
5. Location matters. Prices can vary depending on where a patient receives care and where tests are performed. If you need blood work, ask your doctor to send the requisition to an in-network lab. A doctor’s office connected to a health system, for instance, may send samples to a hospital lab, which can mean higher charges.
6. When admitted, contact the billing office early. If possible, when you or a loved one has been hospitalized, it can help to speak to a billing representative. Ask whether the patient has been fully admitted or is being kept under observation status, as well as whether the care has been determined to be “medically necessary.”
7. Ask for a discount. Medical charges are almost always higher than what insurers would pay, because providers expect them to negotiate lower rates. You can, too. If you’re uninsured or underinsured, you may be eligible for a self-pay or charity care discount.
8. There’s help available for Medicaid patients. If you get a bill you don’t think you should owe, file a complaint with your state’s Medicaid program and, if you have one, your managed-care plan. Ask whether there is a caseworker who can advocate on your behalf. A legal aid clinic or consumer protection firm specializing in medical debt can also help file complaints and communicate with providers.
9. Your elected representatives can help, too. While a call from a state or federal lawmaker’s office may not get your bill forgiven, those officials often have an open line of communication with insurance companies, local hospitals, and other major providers — and advocating for you is their job.
Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post’s Well+Being that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House.
Do you have a confusing or outrageous medical bill you want to share? Tell us about it!KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Exploring the HEART of Health
By the way, my surgery and hospital stay went well, and I am recovering nicely.
I’d love for you to follow this blog. I share information and inspiration to help you transform challenges into opportunities for learning and growth.
Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.
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Dr. Aletha
Raymond and I on a recent vacation. My surgery should help me continue to enjoy traveling and fun with my family.
watercress words by Dr Aletha 