I’m sitting here writing this just a little more than 24 hours before I go under the knife for some significant surgery. In the weeks leading up to it I had to go through the nerve wracking process of coordinating everything with my insurance company to see how much of it was covered, when payment is due, yada, yada, yada. All I can say is, thank goodness I do in fact have insurance because it looks like the final tally is
going to come in at about $25,000! Scary! I mean really; Twenty five grand for a couple of hours in the OR? The cost of healthcare in this country is mind numbing. I actually have some common sense ideas on how that could be remedied somewhat and maybe I’ll share those at the end of this entry if the rest of it
doesn’t get too long.
Anyway, the whole business of taking care of sick and wounded people involves some serious $$$$$. It got me thinking about the whole “recovery” industry and why viewing addiction as a “disease” is so
important to it.
The whole disease theory of alcoholism finds at its root the efforts of one of the very first female members of
Alcoholics Anonymous, Marty Mann, who in 1945 formed the NCEA (National Committee for Education on Alcoholism which would later become the NCAD (National Council on Alcoholism and Drug Dependence). It was determined by this group that alcoholism was indeed a disease and that it was a public health problem and responsibility to address it. This declaration naturally helped in the growth of AA because if alcohol dependency were to be viewed as a choice rather than a disease, nobody would be in need of a program that declares its members as powerless over the condition.
Despite various surveys of physicians that showed only 20-25% of them believed alcoholism to be a disease, the AMA (American Medical Association) still gave the disease theory its thumbs up opinion.
The following comes from the Wikipedia entry on the subject;
“Between 1980 and 1991, medical organizations, including the AMA, worked together to establish policies regarding their positions on the disease theory. These policies were developed in 1987 in part because third-party reimbursement for treatment was difficult or impossible unless alcoholism was categorized as a disease. The policies of the AMA, formed through consensus of the federation of state and specialty medical societies within their House of Delegates, state, in part: "The AMA endorses the proposition that drug
dependencies, including alcoholism, are diseases and that their treatment is a
legitimate part of medical practice."”
BOOOOOM- This opened the floodgates of $$$$$$ into the equation.
Back in 2007 I checked myself into an outpatient treatment program at a prominent hospital. I was diagnosed with a dual diagnosis (alcoholism/depression) and my indefinite treatment was quickly authorized and covered by my insurance. I found the whole experience useless (I’ll blog about
this one next) but the point here being that the costs were mind blowing. If the disease classification were not in place, these ineffective programs wouldn’t be
Then there is the whole group of “healthcare professionals known as LDAC’s (Licensed Drug and Alcohol Counselors) who also probably would not exist if it weren’t for this designation. Unfortunately, these are the people that make up the majority of the staff to be found at “in-patient”treatment facilities, approximately 90% of which are based on the 12-Step treatment model. These 30 day forays usually cost an average of
$1000/day!!!! That’s a Hell of a lot of money for faith healing!!!!! While insurance companies usually do not approve these expenditures, somebody has to pay for it!!!! It’s big business folks.
Then there is the organization of AA itself which most of its members proclaim isn’t about making money at all. Well all of those 1$ donations in the hat and sales from their literature adds up quite nicely. The head of their national headquarters in New York pulled in over $200,000 last year. Not a bad gig if you can get
So, even though most doctors don’t buy thedisease theory and the fact that more people choose all by themselves without any intervention or treatment to end their addictions, it continues to be the
HMMMM, wonder why ($$$$$$$$)
Oh, as for my two cents on a step in the right
direction for healthcare in general….
1-In most states there are no more than 2-4 insurance companies that are “authorized” to provide medical insurance. If you want the free market system to work, then it has to be just that. Open it up to ALL insurance in all states to be able to compete with one another and watch what happens to the premium costs.
2-Hospitals just arbitrarily put $ figures on what they charge for EVERYTHING and they are usually nowhere near aligned with their actual costs. Medicare actually analyzed all these costs and won’t pay a
penny more than what is reasonable for the actual costs and a slight mark up so that the hospitals can remain viable. The insurance companies, however, are at the whim of hospital administrators as to what they have to pay. If you make that an even playing field for the Ins. Companies then they would also be able
to significantly reduce OUR costs as well.
Anyway, it is now less than 24 hours until check in-Oh joy!!!!! Wish me luck and I’ll talk to you all real soon