Home Publisher's Note The Value Bitch Slap
Publisher's Note
The Value Bitch Slap
September 2012

As a financial journalist over the last decades, I have wrestled with the concept of value. It is, naturally, fundamental to a discussion of prices, markets and other such things with which money scribes concern themselves. Before, as a bond trader, 1980s Master of the Universe (and, increasingly at the time, coke addled legend in my own mind)  I traveled the world's financial capitols where I met legions of vastly overpaid financiers who could quote you the price of everything, but understood the value of nothing.

Fundamental Value

I would sit on the bond desk and watch colleagues get caught up in the mania of phantasmagorical prices. Always always always, at some point, fundamental value would reassert itself and someone on the desk, caught up, would get their head handed to them. It was at this time that I began to come up with, kind of haphazardly I admit (consider, please, what I was on) something I called the value bitch slap - that usually jarring moment when fundamental value reasserts. Later on, as a money writer, I saw a lot of people get slapped around, a lot. I watched on the wider Wall Street stage as the broker went the way of the dodo bird, his middleman role sitting between counter parties exposed as worthless by the introduction of the Internet and discount do-it-ur-self investing. Home Depot did the same to greedy contractors and Southwest did it to coddled protected hub-obsessed and vastly over unionized airlines. All of them, and more recently virtually every single home owner in the U.S... value bitched slapped!

$20K Affordable?

As a voluminous consumer of addiction treatment products and services over the years, I began to suspect the industry might have a bit of a value issue. (Like all medical services, frankly) Suspicion quickly turned to certitude as I criss-crossed these United States studying the treatment business as editor and publisher here. I'd listen to people insisting that $20K for 30-days was "cheap" and "affordable," my objections swept aside by intra industry, much higher price comparisons. Of course, the first sign of a value fall down is a micro relative price focus and failure to link prices to the wider real world. (Remember those "cheap" million dollar Palm Beach shacks?) $20K is nearly half the annual median income for a U.S. family, a lifetime income for dozens of African families and totally unsustainable for a highly repetitive addictions intervention.

The value bitch slap is coming to a treatment center near you...let us know how it feels.

Ted Jackson

About the Publisher

Ted Jackson is Treatment Magazine's publisher, editor and majority owner. A veteran financial journalist, Mr. Jackson's work has appeared in newspapers and magazines worldwide, including the Financial Times of London, The Irish Times of Dublin, Chicago Tribune, Toronto Globe & Mail, Reuters and hundreds of others. Mr. Jackson was among the five founding bureau chiefs at Bloomberg News, setting up the Canadian news operation for feed into Bloomberg's global wire. A former bond trader, Mr. Jackson worked on trading floors in Chicago, New York and Toronto.

Comments (3)Add Comment
written by lee mccormick, December 22, 2015
Then there is this, which has gone on for years with endless reports to State agencies, Insurance companies, aw enforcement and no one cared. Now it makes a rag paper and people shake their heads nd go back to their busy business. The treatment business has no interest in cleaning up it's own messes. That would require questioning business models created to feed ebitda not client out comes and a reworking of how treatment is valued through out the continuum.
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It's time for the treatment field to evaluate our priorities and have the courage to tell the truth!!
written by Rocky Hill, November 23, 2012
Having watched the demise of the Charter Hospitals, Compcare etc., the advent of managed care and, now, the emergence of the "boutique" treatment programs, I was ready to ride away from the clatter into retirement. Ted jackson's article and Mrs. Canton's letter remind me why I'm not done. I have had the privilege of working with some of the most committed people in the field like Dr. Joe Cruse, Dr. Paul Ohliger, Mark Greenberg, Claudia Black, Lorie Dwinnell and many others. All carried a committment to the alcoholic, addict and family at the center of their mission. Unfortunately, too many of my colleagues are now more interested in maximizing their entrepreneurial mission on the backs of the vulnerable addict and their family.
I would encourage any reader to explore ROGUE REHABS by John Hill, staff writer for the California Senate office of oversight and accountability. Our industry has become flooded with too many whose primary goal is to make money. Why is it that the large inpatient programs are so overtly against the use of buprenorphine despite the evidence to the contrary, thereby closing the revolving door of relapse and re-admission? Treatment doesn't need to cost $20,000 and the only good treatment is not defined by where you sleep. Recovery is shared from committed staff to desperate patient and doesn't need to include "call centers" staffed with salespeople who are paid on commission and wouldn't know the difference between benzodiazepines and a line of coke but are ready to tell callers all about how serious their condition is and that without their program, they are doomed to failure. Their favorite line is "well, how much is your daughters life worth"? As long as they get that patient in the door, they get their commission and they will tell them about horsies in the living room and daily massages if it will do the job. Callers deserve to have trained, experienced professionals answer their questions and make referrals to the program that will give that person the very best chance at recovery. Afterall, it may be the last chance they get.
I am sick of programs that espouse "evidence based treatment" and than refuse to use buprenorphine or tell their xanax patient that they are detoxed because they switched them to a long acting benzo the day before they discharged them. It isn't a surprise to the staff when the patient and family are calling confused by the myriad of withdrawal symptoms that have enveloped them but they, usually, blame it on the patient for not going to enough meetings.
It is time to clean up our field so that we can, again, be proud of what we do.
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High Treatment Cost Drives Former ASAM Pres To Take His Life
written by Jacquein Canton, September 28, 2012
Not sure I'm on the same page (although it seems so) with your publisher's note re 'value bitch slap', but from my perspective, it couldn't happen soon enough. My husband, a board certified psychiatrist for over 35 years, became addicted to cocaine 25 years ago. He went into the physician's program, came out, became board certified in addictionology and was a major player in Atlanta treating licensed professionals, was president of ASAM and gave a talk on dual diagnosis before it was even heard of. Worked his sobriety program for 23 years.

Unfortunately, at the age of 65 and still going strong, due to overdependence on Ambien, he relapsed. Having had to go on Medicare, the real estate and stock market downturn and depression to boot, there were no funds for the outrageously expensive physician's inhouse program required by the board. He committed suicide before we could get the funds together for his treatment. A good man who knew this addiction business and CARED was lost due to what I call plain greed.

The only thing I have left to honor him is his story, which will be published one day, along with my desire to have a treatment center in his name accessible, yes, to doctors and lawyers, the licensed professional, whom he treated that also need assistance in their time of need as well.

Thank you for sounding the alarm bell, I'm assuming out of your mutual concern as well for the everyday working American who makes even less.
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