Where do you start to fix a broken system?

Have you ever seen so many broken parts in a given situation that you don't know where to begin with efforts to repair something?  That's where I am in my thinking in regard to how our society is handling this opioid issue.

There are so many areas that need repair.  Maybe, if we focus on one specific area, some of the "lesser" areas may be, somehow, automatically repaired.  I don't know…

In my efforts to understand the differences between how private insurance reimburses detox and rehab facilities compared with the Medicaid system, I've been told the following:

Private insurance pays $800 to $1,000 per day for detox and rehab services.

Medicaid pays $150 to $200 per day for detox and rehab services.

The result of this difference is that nearly 100% of the people on the streets of Kensington who are trapped in the addicted and resulting homeless phase of their Substance Use Disorder are reliant on Medicaid and cannot easily gain entry into detox facilities that provide care with the dignity and respect which is due to any human being.

The typical time spent in the first phase of detox and rehab is 30 days.  That means that:

Private insurance pays out $24,000 to $30,000.

Medicaid Insurance pays out $4,500 to $6,000.

The argument is made that Medicaid and our society simply cannot afford to pay private insurance rates for care.  Here's the flaw in that thinking…

The end result of not paying private insurance rates for medical treatment due to our citizens with Substance Use Disorder is a tremendous financial expense that comes along as a result of not paying upfront. 

The following is a very incomplete list: 

• Additional police coverage in areas where homeless Substance Use Disorder patients gather
• Medic units that try to keep up with all of the overdose calls and supplying Narcan to those who choose to carry it
• Shelters
• Jail and not rehab beds filled with Substance Use Disorder patients.
• Guard's wages and administrator's salaries at those jails
• Court expenses: Judges' salaries, their offices, and staff...  The courtrooms themselves
• Medical expenses to emergency rooms and hospitalizations for issues that are the result of being homeless but are not specifically the Substance Use Disorder itself.  Examples are pneumonia, broken bones, cuts, etc.
• A lifetime of lost tax revenue from that 25-year-old who could have found healing and has overdosed.
• That same person's child(ren) who may end up being raised by their grandparents who are on limited retirement incomes or moved to the foster care system and the costs related to that process.
• Funds spent by outreach groups trying to do what they can in light of our societal absence of proper funding and care to these Substance Use Disorder patients.
• Funeral expenses

I'm sure that you can add other items to this list. 

In doing what I do on the streets of Kensington, I hand out Christian song sheets.  Each one has the following statement on it:

Say this to yourself every hour of every day:

I am an inspirational human being made in the image of God and I am worthy of dignity, honor, respect and love.

As a society, we must treat our Substance Use Disorder citizens accordingly.