Money Makes the World Go Round.

About 3 years ago I sat down with the COO of a private insurance detox/rehab facility. I asked him why it was not possible for that facility to accept Medicaid-reliant patients who carry the same diagnosis. He helped me understand the basic issue involved. 

It boils down to money:

Private insurance pays (in round numbers) $800 to  $1,000 per day for professional services. Medicaid pays $150 to $200 per day for the same. That is a staggering difference in reimbursement. There is no way for a private insurance facility to provide proper services as per its philosophy on what those services should be at the Medicaid rate of reimbursement.

Money Makes the World Go Round.

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As I shared with you in a previous blog, one Medicaid reliant couple who I've been getting to know in recent weeks shared with me how much money it takes to purchase the drugs that they feel they need.  They must spend $500 in a 24-hour cycle.  That's $250.00 for each of them 24 hours each day, 365 days each year including all holidays.

For every 24 hours that this young couple is in active substance use, she as the female in this deeply committed heterosexual relationship must earn $500 by doing ‘dates’ with random men who pick her up.[1]

Think about that and now think about this…

At the Medicaid rate of reimbursement, these two individuals[2] are earning more money in any 24-hour cycle through prostitution[3] to support their addiction than is being paid through Medicaid to provide healing to them from their addiction. 

Money Makes the World Go Round.

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The males who provide the funding for sexual 'services' are often referred to a 'Jawns.'

Collectively, Jawn[4] reimburses for sexual 'services' women in addiction on the streets of Kensington at a substantially higher rate than does Medicaid provide for professional healing services to this same population.

If Medicaid paid more than 'Jawn' we just might see more healing.

Money Makes the World Go Round.

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[1] Additional perspective: If each 'date' earns her an average of $50.00, that is ten 'dates' that she must perform in every 24 hour period.  It's not 9-5 or 3-11 or 11-7.  It's every 24 hours around the clock.

[2] who very much would like to be healed from the active use phase of their substance use disorder

[3] and all the hazards thereof

[4] Sometimes used as a first name of sorts when referring to one.