When I got sober, I went to a rehab, halfway house, and individual therapy sessions with my counselor. Each of these levels of care cost significant money to stay in. I think the treatment center was around $30,000 for 28 days, the halfway house was about $5,000 a month, and the individual sessions were $150 or so per week. Altogether, I was paying a crazy amount of money for help with my addiction and I quickly became skeptical.
At first, when I was in that treatment facility (which shall remain nameless) I had no idea how much it was costing my parents. Then I heard from a staff member that it was so expensive, so we should be taking it seriously. I was amazed. Immediately, myself and a few of the other people around me thought, “What a racket! They’re charging us how much to sit here?!” With a few calculations, we came to the conclusion that the treatment facility has to be making a good bit of money off of us. I developed the same line of reasoning as I stepped down in levels of care over the course of a year and a half.
Now I Work For Them.
A few months after this, I started on my career on the other side of treatment. When I got involved with client care I began to listen when my boss’s boss talked about numbers. I realized that even some of the biggest corporations didn’t always make serious financial profit off their business model. When I was a patient, I wasn’t taking a few things into account.
The first of these points is the price of high-quality treatment professionals. Most people in the field are working in addictions because they’ve been personally affected by the disease in one way or another. They aren’t working in the field because it’s lucrative. I was told time and time again in college that if I’m looking for money, I probably should just switch majors completely. All of the things that occur within the walls of treatment centers are life changing for the client. The therapist literally has the power to alter the course of someone’s life with their words. Of course they should be paid handsomely for keeping someone out of jail or away from overdose. And yet, even though they probably should get paid as much as nurse practitioners, they don’t. So where else is the money going?
From being involved in a huge treatment center, I also started to learn about something called scholarships. These scholarships helped hundreds of people each year to get treatment without paying a dime. Of course they had to be eligible and I didn’t really know what that meant. But I came to learn that my corporation was handing out hundreds of thousands of dollars to people who needed it every year. I was still cynical though. I figured that the corporate barons wanted to overcharge the people who could afford it so that they could give away more money and look like generous philanthropists because of it.
What I failed to recognize was that almost all of the money used for scholarships came in through grants and donations. The price of treatment wasn’t as expensive as a high end car to offset free-rides. But then why was it so high?
The Healthcare System
Another piece of the puzzle came from a class that I had in college about case management. Somehow we got onto the topic of insurance and I was gobsmacked by the realities of the world of authorizations and policies. Most of the reasoning behind addiction treatment prices stemmed from the existing healthcare costs in the United States. Our healthcare is largely commercialized and it seems that our growing mental-healthcare followed suit. Insurance companies make a killing off of American consumers and they have the power to make their own rules with treatment centers. Since they already did this in the medical field, why not just extend it to recovery from addiction?
Although I didn’t fully understand everything that was going down with the insurance companies and treatment centers, I got the general gist. It seemed like some rehabs could charge a lot because if the patient truly needs it, the insurance will have to cover it. If they don’t, they might lose their client, as morbid as that might sound.
“It’s a business first. Businesses make money.”
There was one last thing that my boss pointed out to me around this time. He said something like, “You know rehabs do help a lot of people, but they’re businesses first.” What he was alluding to was the fact that in order to continue helping people, they need to make money. People advocate for addiction and mental health treatment all the time but without making money, the industry would just cripple itself. Just like Amazon or Google, the CEOs make lots of money and the people at the bottom make less. The only difference is that the treatment facility helps save lives, not sell laptops. If they wish to grow, they need to make smart business decisions. If they can charge a lot and help more people because of it, more power to them.
“Okay, okay, I get it.”
At the end of the day, I don’t try to assume that I know everything about the business side of addiction treatment, but I get it a little more now. High-quality counselors come at a price, scholarship amounts are generous and enormous, insurances are set up to make money, and these facilities are businesses first. But at least they’re helping thousands, if not millions, across America.