00:00The system itself is designed to keep you sick. Every time you relapse, the rehab makes more money.
00:07And the costs go up and the insurance companies, you know, you think the insurance companies are going to lose money every time you go.
00:14But they are looking at the entire cost because they collect friction from those costs.
00:21It's like Lloyd's of London. Lloyd's of London would rather have one boat sink a year or a hundred boat sinks a year.
00:31Fragmentation is taking occurring in the response to responses.
00:37You know, there is no coordination between all of the needs and the institutions that could help with this problem.
00:45Housing and law enforcement and health care and mental health care, there's no coordination.
00:53And it's a fee-based service system.
00:56So people are, just like the medical system, people have an economic incentive to make sure you don't get well.
01:05And that's not saying people who work in these, you know, as caregivers don't want you to be well.
01:11Well, of course they do. The system itself is designed to keep you sick.
01:16Every time you relapse, the rehab makes more money.
01:20And the costs go up. And the insurance companies, you know, you think the insurance companies are going to lose money every time you go.
01:28But they are looking at the entire cost because they collect friction from those costs.
01:34And it's like Lloyd's of London would rather have one boat sink a year or a hundred boat sinks a year.
01:44They'd rather have a hundred because then everybody is buying the insurance and the cost of the pie goes up and they're collecting friction on it.
01:52Oh, everybody along the way is making money on fee-based services.
01:56And ultimately, what we have to do at HHS over the next three years is do everything we can to switch the model at CMMI and CMS and HRSA and SAMHSA to coordinate response so that somebody is in charge of that addict.
02:17Somebody is accountable as he moves through the system and to move to outcome-based services where people have an incentive to make sure you don't relapse, that there's a strong economic incentive.
02:31You get paid one price, you're treating that individual, then you follow that individual for three years, you're responsible for all the costs.
02:38That will bring down the cost because then people will look.
02:42We have lots of evident-based treatments.
02:45We know what works.
02:47We're not doing it well because nobody has an incentive to do that and so there's no accountability.
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