Medical System Rant and Response: Perspective of a Substance Abuse Counselor

• Published date: 01 September 2016
• Author: Bonnie Stabile,Scott Metzger,Kathleen Kane‐Willis,Katharine A. Neill,James Swartz,Jeremy Mayer,Timothy Mayer
• DOI: http://doi.org/10.1002/wmh3.200
• Date: 01 September 2016

Medical System Rant and Response:

Perspective of a Substance Abuse Counselor

This commentary features a brief description of a frustrating medical experience by a U.S. health-

care provider, with responses offered by several experts from various perspectives of the health-care

system.

Jeremy Mayer, Timothy Mayer, Bonnie Stabile, Kathleen Kane-Willis,

Scott Metzger, Katharine A. Neill, and James Swartz

Health-care providers are on the front lines of care and their ability to inf‌luence outcomes is

importantly shaped by policy. This rant by a substance abuse counselor expresses the point of view

that Medicare reimbursement actually contributes to our opiate crisis and wastes vast sums of

money. This forum allows for the venting of such a viewpoint, with responses offered by several

academic researchers whose work is expressly intended to contribute to the crafting of public policy

solutions to crises such as the heroin epidemic. Any such solutions ought to take into account the

experiences of those most intimately acquainted with the experience of implementation.

KEY WORDS: heroin, Medicare, methadone

The Rant

As Expressed by Timothy Mayer, a Substance Abuse Counselor and Clinical

Director of a Detoxification Center in Florida

Heroin is back with a vengeance. Many of the new users started their opioid

nightmare with prescription painkillers. The current wave has left many millions

in need of professional addiction services. A sizable subset of those in need of

treatment is fully disabled and receiving Medicare as their only health insurance

option.

What a person in need of substance abuse treatment on Medicare f‌inds out is

that their insurance will not pay for inpatient substance abuse treatment the way

private insurance sometimes will.

They will need to gain access to one of the many addiction mill providers

who prey on Medicare clients by admitting them into a hospital setting and

slowly withdrawing them from their drug of choice with other, weaker opiates or

Perspectives on Health Care

World Medical & Health Policy, Vol. 8, No. 3, 2016

344

1948-4682 #2016 Policy Studies Organization

Published by Wiley Periodicals, Inc., 350 Main Street, Malden, MA 02148, USA, and 9600 Garsington Road, Oxford, OX4 2DQ.