March 12, 2019

Is the American Middle-Class Getting Priced Out of Addiction Treatment?

Andrew Burki, the founder of Life of Purpose Treatment in South Florida, offers a response to a recent article on substance abuse and addiction treatment costs in America.

Boca Raton, FL / March 12, 2019 - 

While news stories about the opioid crisis and the now 72,000 American’s dying per year to overdose continue to grab headlines, the question of why we as a nation seem completely impotent in addressing the crisis in any meaningful way continues to go unasked at the national level. The answer is pretty simple really, even if it’s distasteful to say out loud. When it comes to addiction treatment, we still don’t have equitable access to care in this country. That’s the polite way of saying families that can pay cash get full continuums of care, and families that can’t fall through the cracks. America made a serious attempt to close the gap on who gets the best shot at recovery and who doesn’t, over 10 years ago with the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. In short, it was supposed to ensure that these brain diseases were covered by insurance the same way other diseased organs are in physical health. Unfortunately, the passage of MHPAEA hasn’t significantly increased access to high-quality care, although it has caused the catastrophic mismanagement of the extremely limited resources being spent in the large-group insurance markets.

A policy office over at the U.S. Department of Health and Human Services contracted a team of scientists headed by Norah Mulvaney-Day who have recently published their findings on this subject. A March 4th article by Allison Bell at Think Advisor, covers the findings and the effect of parity on both mental health and substance use disorder spending.  One particular finding that Allison pulled out of the report at the bottom of her article really lies at the heart of this issue, though. “It will be important to consider whether the rates that insurers pay are insufficient to attract providers to accept insurance.”

And that’s really what it comes down to. We don’t have a problem with the quality of care in America. What we have a problem with is access to high-quality care due to affordability. We had the same problem a decade ago which is why “addiction equity,” was in the title of the bill. As the middle class continues to get priced out of comprehensive substance use disorder treatment and full continuums of care, it should fall on insurance payers and treatment providers to work out a functional system to provide the large-scale, high-quality care that America needs at a price America can afford. The alternative of expecting desperate families in their darkest hour to set up and operate a bootleg treatment center in their basement for the child they’re trying not to bury is completely unacceptable. This is America. We need to do better than that.


Andrew Burki is the founder of Life of Purpose Treatment and their current Director of Public Policy. He developed “The Purpose Model” to help other individuals whose education or employment was disrupted due to substance use, overcome the soft bigotry of low expectations that many emerging adults experienced during treatment and the early recovery process. Andrew is a person in long-term since 2001. Andrew also holds a Master in Social Work degree from Florida Atlantic University and is a macro level social worker. He is a member of the Young People in Recovery national board, as well as a board member of The Bridge Way School, Philadelphia’s recovery high school. Andrew has also been a member of the Florida Sober Homes Task Force and participated on advisory panels for the Office of National Drug Control Policy and the Substance Abuse and Mental Health Services Administration

Life of Purpose is an addiction treatment center located in: Boca Raton FL, Bala Cynwyd PA, Fort Washington and Philadelphia PA.

For more articles by Andrew Burki


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