Many of the multiple sorrows that befall human beings are beyond the power of government to remove. Many others inflict only transitory pain, since people recover surprisingly quickly from most of life's setbacks and disappointments. But a few afflictions stand out because they cause severe and prolonged distress, affect large numbers of people, and seem at least somewhat amenable to enlightened public policy. Three of the most prominent examples are chronic pain, sleep disorders, and depression. None of them is commonly numbered among the nation's high-priority illnesses. Yet all three offer ex- ceptional opportunities to any government seeking to improve the well-being of the public.
Chronic pain, by definition, is pure suffering and unhappiness. It is also surprisingly widespread and very costly to society. The Ameri- can Pain Foundation has reported that 50 million Americans live with chronic pain.1 Much of the suffering is borne by cancer pa- tients, the terminally ill, and nursing home residents. But the many forms of pain experienced by those who work are estimated to cost the economy more than $60 billion in lost productivity alone.2 If medical expenses, disability payments, and lost wages are added in, the total burden could approach $100 billion per year.
By all accounts, chronic pain can be effectively treated in the vast majority of cases. Cancer specialists estimate that at least 80 percent of patients with metastatic pain can have their suffering