If you stay well, I get nothing
The very normal and cool business opportunities of addiction treatment.
Rabbit Rabbit, Scam Fam!
You're probably not reading this on the first day of any month, but time is complicated, and superstition springs eternal. I have a good feeling about what we're going to collectively get away with this March!
I didn't do debate in high school, so I never envisioned congressional testimony occupying the pockets of my workday and my brain that it has lately rendered unusable for other matters. As a spectacle, it's somehow both more dull and more engrossing than I would have anticipated. As a function of government, I find it perplexing. Are the stakes of this performative interrogation the vital health and future of democracy or is everything meaningless, lol? If you're lucky and/or trapped in an airport that has the cable news volume turned way up, strangers will scream conflicting answers to this question plus incorrect definitions of racism into your face.
The whole Political/Cultural Event Circus makes me want to bury my head in the sand, by which I mean immerse myself in an incredibly depressing story about the way the addiction treatment industry exploits human vulnerability and inhuman bureaucratic oversight to profit massively. Thanks to this brutal Mother Jones piece, “Mom, When They Look at Me, They See Dollar Signs” by Julia Lurie, we can all do just that! Here's a quick summary of how it works:
The addiction community has a name for what happened to Brianne [one of the subjects of the story]. It’s called the “Florida shuffle,” a cycle wherein recovering users are wooed aggressively by rehabs and freelance “patient brokers” in an effort to fill beds and collect insurance money. The brokers, often current or former drug users, troll for customers on social media, at Narcotics Anonymous meetings, and on the streets of treatment hubs such as the Florida coast and Southern California’s “Rehab Riviera.” The rehabs themselves exist in a quasi-medical realm where evidence-based care is rare, licensed medical staffers are optional, conflicts of interest are rampant, and regulation is stunningly lax.
In a world full of scumbags, rehab brokers, who use drugs and cash to lure people struggling with addiction to rehab, really shine. It's a job that appears to have risen fully formed from a weird dream Nancy Reagan had once (upon her death, she still couldn't decide if it was a nightmare or a sex fantasy). Here's a Facebook messages one of them sent Brianne:
“I can fly u down and shit,” he wrote. “I have a really good relationship with the owners I promise you they won’t call ur mom.”
It's not legal to pay clients for treatment (or to give them drugs), but it is incentivized, provided the clients are on a family member's good insurance plan or have one of their own. Just like it’s incentivized for the rehab centers to have repeat patients. Here's an EVP for a non-profit advocacy group describing the business model: “If I’m a Malibu rehab, I get to bill the insurance company when you come. Then when you come back, I get to bill the insurance company again. But if you stay well, I get nothing.”
In the article, Lurie does a terrific job of identifying the various loopholes and regulatory quirks at every stage of addiction treatment that make it possible to profit. One of the reasons the rehab racket works so well is that any changes to existing payment policies will make it harder to treat an already very difficult to treat disease. In a world that relies on cash to function, who can blame a scammer for grabbing some where they can?
Scam with more cheer than this week's edition offered,
Ruthie
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My Week in Consumption
Last year my friend Fritz recommended the movie BPM to me. I somehow got it into my head that it was a documentary and when I finally got around to renting/watching it, I was like, "Wow, this French documentary about ACT UP in the '90s has extremely high quality footage, I wonder who was filming all this?" Then I got to a sex scene and realized I was watching a scripted feature. As a scripted feature, Fritz was right, it's fantastic, renting it was one of my better uses of $2.99.
In my never-ending quest to be less cold, I purchased these fleece tights and these weird USB-powered heated gloves. They're both fine? IDK, maybe having an icy heart means I will never know true warmth.
Never Ran, Never Will took me a long time to get through because I found the youth football stakes higher than I could comfortably stomach. I mean that as praise even if it doesn't sound like it. Albert Samaha is an outstanding reporter and writer, and the book feels like essential reading for living in Brooklyn during this decade.