Recovery is slow. The insurance companies have managed to impose a 28-day standard on treatment programs, though anyone who works in the field knows that 28 days is a joke. But money is the controlling factor. It might be pointed out that the most hopelessly naive and utopian belief is that the exchange of money and property is self-regulating, and borders on the sacred. Adam Smith certainly did.
The residential program I worked for took the indigent. They'd agree to repay the House within six months of departure, the total calculated on a sliding scale based on existing assets and projections of possible income.
Not all our clients were indigent. We were the best program around, and people with money sometimes sought us out. That was good because the groups were intense, with built-in gaps and points of contention -- street people, businessmen, academics, rich kids, housewives, "isolatos." They learned from each other. We didn't take in anyone who wasn't a hardcore drunk, so by definition they were ready to touch each other or die.
We used our money carefully, and knew it for a tool. Money is scarce in a real program. Ours wasn't coming from insurance companies, it was coming from the state and we couldn't throw it away on those who could find help elsewhere.
Hardcore drunks take time. Insurance companies don't want to give you time. Insurance companies, as a matter of fact, want your ass out of wherever you are -- and that includes life if you're expensively sick. And with true, moronic, free-market-musketeer idiocy and contempt for the lives of the damaged, they choose not to understand that if you get out too fast the first time, you'll be back, whining recalcitrant bastard that you are.
In fact, in any contest between an individual and an insurance company, the individual is always right. This is a probability-based axiom -- the same sort of thing the company uses when it chooses to let a child die rather than provide the latest treatment. If we operate the way they do, we'll simplify a lot.
If an insurance company goes to court, throw it out. If an insurance company is charged with fraud or willful disregard, make it pay. This simplifies much in the way an initial rejection of all first claims that aren't cut and dried simplifies. Apply the standard and assume they're in the wrong. We'll be right most of the time, and we'll save money and lives. How's that for a market solution?
The money factor cuts through everything. The common notion is that the guys from the street are the hard-noses, but they seldom are. They know how easy it is to suddenly have nothing, and what it is to live with nothing. They come in and talk tough for a while, then cry like the rest of us.
The common notion is also that the comfortable think better than the ravaged, but drunks defend their drinking with whatever they've got and that the man or woman with money and comfort has been able to sustain more lies than the wreck who sleeps out on the abandoned track by the overpass.
The well-off can do more damage, over time. They can maintain secret ideas of structure and dignity. These thrive largely on a half-public/half-secret intake of alcohol, looking good and making sure the family looks good, and the closing of any emotional opening, to the kids or anyone else.
They tend to produce a comfortable guy sitting alone in a comfortable chair, late, with a nervous glass full of hundred-proof, sobbing helplessly at some evil, dishonest commercial telling him that if he buys the insurance he'll have a happy family.
Money cuts through everything but the soul. When the soul needs to speak and be heard, money is just static.
Right now somewhere, a drunk is sobbing like a child in front of a warm and loving commercial for a hospital program offering 28 days to heaven and a family made whole.
If we were a decent society and hadn't yet been led down the path to the Great Hall Of Vanity, Sacred Greed & Human Recycling, money would flow naturally to where it's a usable tool -- a substance with neither grace nor compassion that, oddly enough, works best in the hands of those with both.
Larry Kearney is a writer in Larkspur, Calif., whose works of non-fiction include Whiskey's Children [Kensington], a prose narrative of an alcoholic life, and its sequel, A Bar on Every Corner [Hazelden], which won the Independent Publisher's Award for best memoir of 2002. Email firstname.lastname@example.org. This is the fifth in a series.