Want to Know how much Rehab Costs?

Want to know how much rehab costs? 

It’s not pretty.  Buckle your seatbelt. 

When I was writing the post for my sober birthday a few months prior, “Sobriety is A Numbers Game,” I made a note to go back and pull my medical bills for rehab so that I could share what the real costs were.  If you have ever been curious, then keep on reading… 

For any severe drug/alcohol rehab stay, there are usually two parts: 

1. Detox 
2. Rehab 

PART 1: DETOX 

Detox is always recommended when trying to quit addictive substances.  First, it can make your life a whole lot easier and pleasant (I say this metaphorically and with a whimsical smile, make no mistake about it, detox is fucking hell), and secondly, if you go cold turkey from alcohol or benzos (benzodiazepines), you can have seizures that can kill you.  This is why it is never encouraged to detox on your own, you should be monitored in a hospital setting by a doctor. 

Unfortunately, as addicts, we usually try our first detoxes on our own – partly because you forget how dangerous it is (the this won’t happen to me syndrome) and in the moment you frankly don’t give a shit.  If you have ever been through severe drug withdrawals, you get this.  When you’re wrapped around a toilet in the fetal position on the cold floor, leaking from every orifice in your body, life is broken down to the most basic of elements:  just survive. 

Then there’s also the unspoken truth – we’re scared shitless of the medical costs that a hospital visit might indenture us too.  Hospitals are seen differently by addicts.  They aren’t looked upon as a bastion savior of all health and well-being that most people revere them to be; in our world it’s a last resort, an institution shrouded in fear that might get me stable and a glimpse at a second chance, but at what final cost?  Yet we’ll get to that soon enough… 

A medical detox unit can be located in a hospital or be private.  Sometimes a hospital might have a detox unit and rehab onsite, or a rehab might be offsite by itself.  A rehab facility can either be inpatient (you stay overnight), outpatient, or a combination of both.  You shouldn’t get admitted to rehab until you have been stabilized at detox (at least you hope this is the case). 

In my situation, I first visited a private rehab not knowing the difference.  It was late morning and my DT’s (delirium tremens) were starting to show.  They took my vitals and said they couldn’t admit me, I had to go to a hospital detox immediately. 

So, on the afternoon of 10/22/16, I was checked into my local hospital detox unit and checked out 10/28/16.  I was there part of 7 days and 6 nights to stabilize me (I stress stabilize, because this is only the very first few steps of the marathon to come.  You come out of detox extremely fucked up and your body is still in shock trying to figure what the fuck is happening to it.) 

What did that wonderful experience cost me: 

• No insurance (what I was billed):           $32,161.54 
• I paid with insurance:                                 $6,780.00 

Let’s just let that sink in for a second.  Holy fucking shit!  Over $32K for not even a full week if I don’t have insurance (and these are in 2016 numbers!  Just imagine what they are today).  And this is only detox, to stabilize me, I haven’t even got to rehab yet! 

Further looking into this bill, it’s absolutely no wonder why medical costs are one of the leading causes of bankruptcy: 

The detox unit charges me $4,522.39 a night for my bed, and I’m sharing a room.  This is probably well over $5K in today’s dollars (I’m not hooked up to any machines and only a nurse monitors me – if you want to justify these costs by all the hospital overhead, go ahead, it’s the next part that absolutely blows my mind.)  The thing that really starts to get me are all of the hidden mark-ups.  A pill that would cost me about $0.11 from my pharmacy ($10 prescription for 90 pills), they charge me $72.00 per pill… that is not a typo, per pill I said!  Why???  Because I’m lying in a detox bed the pill’s cost magically transforms to a 65,000% mark-up?  And this goes for vitamins and any other basic service.  I can go on and on with these insane billing examples, but I don’t want to bore you for the entire post.  You get the picture. 

What the fuck is going on here? 

When I am at my most vulnerable state, seeking expert medical treatment and care, I’m getting screwed in my wallet.  So this is American healthcare?  This is what the industry has become?  Looking at this bill changed my entire view on how I see our medical system. 

How does the hospital justify recklessly overcharging patients who are in its care? 

I’ve always adamantly believed this: when medicine becomes a business, a for profit enterprise, then it ceases to be medicine.  Profit, rather than the patient, becomes the driving factor. 

There are a lot of doctors in FI so I’m curious on their perspective here.  Maybe I’m way out of line, but I feel strongly about this.  If the goal of healthcare is to make a profit from me, and give me the least bit of treatment or insurance possible, then my best interests as a patient are no longer being served.  What is covered by insurance, not what a doctor recommends, is now dictating what my treatment will be. 

Unfortunately, healthcare has become a conveyor belt to drain our bank accounts.  And I don’t know the answer to this ongoing problem… keep it privatized?  Nationalize it?  But what I do know, is that it is failing us in the addiction world.  The conflict of interest has never been clearer.  I don’t like writing this, but I no longer look upon the medical industry with respect, I look on it with fear, fear that it is a leech that will bleed me dry someday. 

So where do we go from here? 

Your guess is as good as mine… 

PART 2: REHAB 

Jumping back to rehab, there is everything under the sun for this part of your recovery: celebrity rehab resort centers in Malibu and the Pacific Palisades (I’m not going to get into how shitty and predatory these fucks are), you have bare bones places like the salvation army, more traditional Betty Ford centers, Hazelden and everything in between. 

There are a million opinions of what works, doesn’t work, or where you should go.  Each person’s experience is unique.  But for every great rehab there are probably five terrible ones only chasing the almighty dollar.  This is just like the medical insurance companies, they want to make money, and addiction is a wonderful industry that pays big bucks.  How great is it if you have a client who is addicted to the product that is killing them? 

Returning customers anyone? 

For my stay, I chose a bare bones facility that was known to be very strict and hard on its clientele.  I wanted a place that was taking me as serious as I was taking my disease. 

When I checked into rehab from detox, I stayed a few days overnight and then switched to outpatient.  Overall, I probably spent three weeks total in the program. 

Rehab total cost: 

• No insurance (what I was billed):      $12,541.00 (this is a smoking deal) 
• I paid with insurance:                            $5,665.60 

I’ll add to this, I was educated, older, serious and knew the medical costs would be high.  So my goal was to get in there, work hard and get out ASAP.  You need to be your own advocate when it comes to these programs and the costs. 

My price above was a great deal.  Someone else might need 30 days of inpatient care and another 30 days of outpatient and their bill could end up being $50K-100K.  Every place charges differently and every patient is unique in the treatment that they need.  But the more educated you are, and the more knowledgeable about the system and insurance, then the more equipped you are to deal with the costs, question charges and negotiate smaller fees. 

My total bill for 30 days of treatment (detox+rehab): 

• No insurance (what I was billed):   $44,702.54 
• I paid with insurance:                       $12,445.60 

And if I get out and relapse one day later, you do it all again and probably with much longer stays and drastically higher costs.   

From the Smart Recovery Website, “According to the National Institute on Drug Abuse, 40 to 60 percent of people who go through addiction treatment programs go on to slip at least once. In fact, many people have multiple setbacks before finally achieving a full recovery.” 

That’s what’s so terrifying.  Relapse is the norm.  These costly treatments become a revolving door of debilitating debt.  There is no cure; only hope and hard work – and even that doesn’t guarantee you anything. 

How do we help those most in need?  Is there a way to break this predatory cycle? 

The short answers:  I don’t know and not today. 

A lot of early addicts and alcoholics are in denial.  They do one stint in detox and think they are cured.  Then days, weeks or months later they find themselves back in the same spot. 

Maybe they’ll do detox and rehab this time.  But the same thing happens.  They think they’ve put in their time and are cured.  And then the vicious cycle continues. 

If they are lucky, and they finally get it, they find sobriety and can maintain it.  If they aren’t, they either die or live a life in-and-out of treatment, a slave to their substances and unable to quit. 

The real question is how do you pay for this?  If you have isolated yourself from friends and family, you lose your job, you are on the streets, where does the money come from? 

When you look at it from this perspective, from an addict’s eyes, it’s easy to see how people can be crushed by debt so soon.  They find themselves in and out of treatment with a revolving medical bill ticker that just keeps on increasing. 

I’ve seen some people who’ve been homeless and to detox more than 15 times in a single year (without insurance that’s getting close to $500K in hospital bills only).  They can’t get well.  They can’t beat their disease.  And the crippling debt won’t ever be solved. 

When I first asked at the beginning of this article: want to know how much rehab costs?  The dollar amount is easy.  It’s something tangible, people can relate to it. 

But the real question remains under the surface: what is the value of a tortured soul? 

And more importantly, what is the cost to society? 

-Q-FI 

P.S.  Have you ever battled addiction and debt?  Are you in the medical field and disagree with the above?  Let me know in the comments below.