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Providing non-judgmental and non-criticizing support for family and friends of end-stage alcoholics through one-on-one coaching, support groups, blog posts, workshops and public speaking.

Monday, January 30, 2012

Rehab & insurance stupidity...

I am in awe of the stupidity of some rehab centers and insurance companies. Well, to be fair, it could be that I’m the stupid one because I just don’t understand.

A family member’s husband is an end-stage alcoholic and he was transported to the medical center via ambulance. While racing down the highway, he flat lined three times. This man is at the end of his end-stage journey. Fortunately, he was saved and, miraculously, lived through detoxification. Over the past couple of years, he has been through detox about 4 times. Each time he immediately returned to drinking.

Imagine this wife and children’s surprise when he announced he wasn’t coming home right away, but rather going to rehab. Well, OK, so it’s not is first time there either. In spite of that, everyone rallied around and offered up support for his decision.

The wife was asked if she would like to participate in the family program. She has been reading my blog and understands the importance of educating herself and her family in everything about alcoholism. She had never attended a family program before and she enthusiastically agreed. She asked if her husband’s sister could attend with her. The center responded that any family member may attend.

The ladies were excited for the opportunity and began to prepare for the 300 mile trip to the center. They didn’t have a lot of money, so they decided they would bring an ice chest so they could get food from a store and use the motel microwave to heat it up. They used their coupons to shop, cashed in aluminum cans and used every resource they had to scrape up some money.

Then they received the phone call telling them that the center needed payment for the program before they could reserve them a place. The cost is more than $200. Huh??? They were under the impression that they were being invited by the center as part of the husband’s rehab program. They thought the cost of the family program was included in the cost of alcoholic’s program. They were wrong. It not only was NOT covered in the alcoholic’s program, it was also NOT covered under the wife’s health insurance plan.

When I say NONE of the expenses were covered, I mean NONE. The wife not only has to pay the program fee, she also has to pay for her gas, lodging and food. She will not be allowed to use the cafeteria facilities at the center – which she was hoping she could do in order to have one solid meal a day. The program is 5 days long and that’s a long time to subsist on Hot Pockets, sandwiches, tv dinners, oatmeal and the $1 value menu of fast food restaurants.

A hasty recalculation was made and they determined they could not afford for the sister to attend the program. The wife asked for some money from her husband’s parents and she was able to pay the fee. She left on Sunday night and will return on the following Saturday after her husband’s release.

My irritation lies in the fact that the rehab center is so self-serving that they did not include the family in the alcoholic program’s cost. What is up with that?? Doesn’t everyone in the substance abuse industry understand that to return an alcoholic to an uneducated family environment is like throwing a fish back into a polluted pond?? Isn’t that common knowledge?

I find it counter-productive to supply an alcoholic with all the keys to achieving and maintaining sobriety and also expect the alcoholic in turn to educate the family. The alcoholic has all he/she can handle just staying inside the sobriety life preserver. The family inadvertently sabotages the alcoholic’s effort, not because they WANT to, but rather because they don’t know any better.

Fortunately, for this alcoholic, the wife has been reading my blog and has my workbook (The Workbook for Caretakers of End-Stage Alcoholics). She was fairly well-educated before she got to the center. But still, she says the program was good for her because it was more of a classroom environment. She didn’t want to demean what she had learned from me, but to hear the same things in a classroom environment made the whole thing more “real.” As a couple they received some one-on-couple counseling and that was extremely helpful.

The couple was very grateful they could gather the funds for the program and have the wife attend. It was money well spent. The only regret was that the sister (who is extremely close to the alcoholic) wasn’t able to reap the benefits. The sister will gain knowledge from reading the blog and helping to update the wife’s workbook.

No one knows for sure how long the alcoholic will stay on the road to recovery. We all pray he will maintain his sobriety. He’s a really great guy, wonderfully devoted father and an award-winning grandfather – that is when he is sober.

If you are a director of a rehab center – do you include at least ONE family member in a family program covered in the fee of the alcoholic’s program? If not – why not?? I truly hate to say this and I hate even imagining that it may be true – but is your center looking forward to the alcoholic’s relapse so they can be re-admitted to your center?? That would let the center reap the financial reward from the insurance company — yet again. Is it a one-for-two kinda thing? One person – two fees?

Just the suggestion of such a thing is so distasteful to me that I hope I get lots of angry comments, not just from my readers, but also from rehab centers around the world. Defend yourself – PLEASE – tell me why it makes sense to NOT include the family program in the cost of the alcoholic’s program.

I know for a fact that there are rehab centers that include a family program. If they can do it, I see no reason why they can’t ALL do it.

And to all the health insurance companies – do you not understand that getting the family member into a program might just prevent health issues later on?? Stress causes illnesses. Alcoholism or any substance abuse causes stress for the families. This is not a new, enlightened statement. So why are the insurance companies so far behind the times? The fact that they do NOT cover family programs as an individual benefit only costs the other policy holders more money. Who do you think pays the price when insurance companies have to pay out for heart attacks, strokes and a variety of other illnesses? The premiums go up and everyone with a policy pays. Well… maybe that’s what they want… for us to pay higher and higher premiums. I guess there may be big money in that.

I’m just a simple girl. You can add to that – loud-mouthed and opinionated. I’m not a medical professional or an insurance expert. However, I am not stupid or ignorant. I strive to be informed. Maybe I have unrealistic expectations as I have a tendency to do that, but I expect anyone dealing with alcoholic/addiction rehabilitation to have a realistic, informed and intelligent program leading to sobriety. I expect our insurance carriers to do the math and stop sticking their heads in the sand as to the far reaching consequences of addition.

Does anyone else see the absurdity or am I the one who is off the rocker?


Syd said...

Linda, insurance companies and rehabs are about making money. That is what they do. I am not a fan of rehabs or insurance companies. There is a free family program which I attend. It costs nothing if you choose or you can drop a one dollar bill in the basket at a meeting. I have learned so much about alcoholism there and how I can take care of myself around it. Al-Anon is a simple program and a good one. It would be good to see that mentioned as something to help those who have family members dealing with alcoholism. We go to treatment centers and hospitals to inform families about it. Some want a cure for the alcoholic--we don't offer that! And most rehabs do have AA meetings which have also helped millions at the same one dollar a meeting cost. It takes willingness by the alcoholic to go and it takes admission of being powerless over alcohol. I hope that this fellow gets that.

Linda (The Immortal Alcoholic's Wife) said...

Syd -- I'm not saying that Al-Anon is not worth going to. I agree Al-Anon has a lot to offer the family. I've been to a lot of meetings, all over the country from Connecticut to California, but I have never learned about the biology of alcoholism in any of those meetings. I learned it at the first family program I attended compliments of the Navy.

In my opinion, Al-Anon is great if you understand that their program is not about getting the drunk sober -- it's about how you can survive the insanity. Too many people go to Al-Anon searching for the wrong answers.

All I'm saying is that if a rehab center is going to treat alcoholics -- they should treat EVERY aspect of the condition. Not including the family feels like slapping a band-aid on a cut that needs stitches.

The man in question is very familiar with AA -- even attends when he is so drunk he can't see. I'm thinking that because he knows where help is -- he just might make it this time. At least I hope so.

ADDY said...

I agree it seems stupid to exclude the family from the costs, but here in the UK the families are excluded from the programme altogether. When Greg was offered rehab, he would have had to go away for 6 months. I would not have been allowed to go with him or indeed have much contact with him. Because he did not want to go away at all, he declined the idea of rehab altogether. My view is that the so-called professionals ought really to reconsider the way they treat alcoholics and their families as the current system is grossly lacking.

jo said...

first thought was welcome to reality of the world of addiction. i wasnt surprised at all.

the one mine went to kept him 7 days...said he was their priority (his insurance was paying them, why didnt they just say that?) and he promised them the world..begin drinking less than 2 weeks later. are they really this stupid? prob.

true rehab would be a yr or more. absolutely almost no insurance is gonna pay for this. a week here, a month there, is a joke.

i admire his wife for going at all. im way past that point. i have no more trust in me. no more energy to "help" him. he either does it himself or wont. im done pulling his butt along and hurting when he drinks again. if i told a rehab that i would be considered such a bad person for not jumping on the bandwagon of their insanity yet again.

rehabs are about money. society has a need...someone sees a profit. nothing more. and dont tell me the rehabs dont know its useless to do something in so short a time. of course they do. they build up hopes..and insist we can do so much to help...and people think oh cool,,and head up to it. paying all the way to their bank.

i suggest the lady read online,,in real...and educate herself. those rehab programs are a crock...even dr drew has a dismal success rate and he is the brightest specialist i know.

i know. im a realist,or you may say im just done. either way, this is my truth and reality.

jo said...

addy...i think there is a reason families are excluded.

they want the addict to see and know its their problem to fix. many simply lean on the families way too much and find a excuse to blame mom or the wife or someone.

they need to be isolated with other addicts in a intense place and face that mirror. the families have to do the same.

just my opinion.

Sonja said...

i remember my husband going into treatment for 28 days i used to call it the revolving door..he was there 4 times in 3 years his work paid..and our children could join a group there for help..but i was offered nothing..then he went into another treatment 3 times for 60days i had to work and keep things going plus look after the children but i was asked to come at my expense..then he went far away over 4 hr drive for 6 months..and on and on..i remember going to al-anon meetings when i could to help myself..luckily i did not have to pay anything.. the insurance is all about money. the private health care pays..not sure if things have change but i don;t think by much since 1980's.i don;t think anyone got thru to him.its was never him that was the problem it was always either work or the family driving him to drink...and he blamed everyone but himself..its money making and i also believe that there aren;t many good threatment facilities or insurance companies out there anymore...all for profit..even now we wait for the insurance to say yes...we will pay for rehabilitation for a brain injury..they don;t care and we wait while its been 2 months and still waiting for some sort of help for someone in an accident with brain injury.on top of being an alcoholic...he rolled his car several times and hit a tree and was injected out of the vehicle..no response at the scene... has brain injury on both sides of his brain..and they are wondering if it was catastrophic enough..mmmmmmmmmmmmmmmm lets see he will never recouperate and his life is shortened and we don;t even know if he will return to drinking as his brain isn;t wired right anymore and he thinks he can drink just a few. i asked them to come and spend a few days with him and then judge if its catastrophic enough.........its all about the money..corporate greed...if they cared things would be different and they would be more compassionate to help the family as a whole..just my opinion..

BevE said...

I've tried Al-Anon and it's so hit and miss. You could go to a dozen meetings and get nothing out of them. My husband and I went to a Parents Helping Parents meeting early on when our son first started drinking. A mother was there and talked about her daughter who was dying from an heroin addiction - her daughter was down to like 85 lbs. The rest of us just sat and listened - this woman needed to talk - she poured out her soul and tears - no offense to her but I never went back. We needed help too but how could we ask when this woman was suffering so.

Families need one on one help - Al-Alnon may be great for some and help on a certain level - but there is nothing like individual help.

jessecraig said...

Alcohol rehab in the UK has been dominated by medical and 12 step models of recovery. Alcohol Rehab

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Rebecca said...

Thank you!! I agree with you 150%!! I found your blog a few days ago and I have learned so much from reading these last few days. My boyfriend has just entered his 4th inpatient rehab for alcohol in a year and a half. He is only 32 and has only been seriously heavily drinking for about 3 years. He has also been hospitalized 4 or 5 times in the last year.

Until I started reading, I always knew there was something missing from the rehab centers. You hit the nail on the head. Besides a few therapy sessions and group sessions (which I don't see how sitting around listening to what happened when this person overdosed for the 4th time, really helps) there is virtually no education for family members-the people that will be paramount to recovery for the addict. If I didn't care enough, or wasn't informed enough to go search for these answers on my own, I would be completely in the dark. While I do know that some of the questions I have probably don't have a hard and fast answer. Some more guidance would benefit him and I tremendously. It just doesn't make sense, like many things in this world.

Thank you for writing this blog. I have been thinking of doing one of my own. The initial idea was to keep sane by expressing myself through writing, but I would like to help people if I could. You are truly an inspiration.