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The Amy Winehouse rehab blues

By Jay MacDonald ·
Tuesday, July 26, 2011
Posted: 9 am ET

The troubled life of British retro-soul singer Amy Winehouse ended last Saturday at the age of 27. While the official cause of death remains a mystery, it's a fair guess that her public battle with substance abuse contributed to her tragic end.

Winehouse thus became the latest victim of the Forever 27 club, named for the age at which other rock legends, including Kurt Cobain, Jimi Hendrix, Brian Jones, Janis Joplin, Jim Morrison and Kurt Cobain sailed into the mystic.

The death of Amy Winehouse serves as a reminder that we've yet to come up with a rational process to address addiction.

Nashville, Tenn., singer-songwriter Todd Snider wrote the theme song for the Forever 27 club with his barroom classic, "Alcohol and Pills":

Alcohol and pills, it's a crying shame

You'd think they would have been happy

With the glory and the fame.

But fame don't take away the pain

It just pays the bills

And you wind up on alcohol and pills.

Of course, we all know how Amy felt about rehab: No, no, no.

The pity is, she had the resources to go, go, go.

Most of us don't. Why? Because rehab is the Catch-22 of health insurance: if you want it, insurers assume you may use it, which triggers all kinds of alarms about whether you have pre-existing conditions that may preclude you from coverage.

Many health insurance policies exclude drug and alcohol treatment outright. That said, even policies that make such exclusions may cover some aspects of supervised rehabilitation treatment under medical care provisions.

But a quick rehab policy supplement that you can sign in the ambulance on your way to detox? Nope, that's not gonna happen.

According to the federal Substance Abuse and Mental Health Services Administration, the average cost of treatment for alcohol or drug abuse in an outpatient facility averaged $1,433 per course of treatment in 2002. Residential treatment for alcohol or drug abuse cost $3,840 per admission and outpatient methadone treatment cost $7,415 per admission in 2002.

Yes, latest figures. From nearly a decade ago. Which may say more than the figures themselves about how far on the back burner we've shoved the topic of treating addiction.

Combine this with the social stigma of rehab, the potential damage to income and even career ("I ain't got 70 days!" per Amy), and the denial and/or bulletproof mindset that so often accompanies addiction and it's little wonder that residential rehab remains an option primarily for the rich and famous.

Winehouse and the other Forever 27ers made a lasting impact on our lives and culture. Unfortunately, their untimely deaths did not have a similar impact on the insurance world, where health insurance in particular still struggles for a workable approach to this complex medical and psychological affliction.

We know that fighting addiction would cost pennies on the dollar compared to its financial impact on society, yet we've been unable to figure out how to do it effectively without in effect enabling drug and alcohol abuse. In our current economic purple haze, the prospects seem dim.

Winehouse may have been reflecting on just these sorts of life's boxed canyons when she wrote:

He said, "I just think you're depressed."

This me. "Yeah, baby. And the rest."

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