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Addiction is a widespread condition, often beginning in adolescence, with new-onset cases possible at virtually all points along the lifespan. It has been estimated that 20% to 30% of our nation's total health care costs are devoted to treatment of the medical, surgical and psychiatric complications of substance use and addiction, whereas around 1% of America's healthcare dollar is spent on treatment of the primary illness of addiction itself. Most addiction care is delivered by counselors, not physicians, and the degree of supervision of that care by physicians varies widely, as does the knowledge, skill base, and quality of the physicians providing that supervision. When persons with addiction do receive care, 80% of the time it is care delivered in or paid for by the public sector: America's private sector health delivery system, the most technologically advanced (and expensive) in the world by far and the mainstream of American medical care, devotes surprisingly little attention to addiction as a primary illness. Most addiction care in America is delivered in a specialty delivery system in geographic locations separate from locations and facilities where other medical care services are provided. In sum, the care patients receive when they have addiction is not on a par with the care they receive for cardiologic, orthopedic, obstetric, or even psychiatric conditions. And the third party payment and utilization review systems associated with addiction care have clearly been separate but not equal when compared to private sector third-party payment, care management, and utilization reviews associated with other medical care. OPPOSING DISEASE DISCRIMINATION

Health & Well-Being
June 1
Taylor & Francis Ltd.

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