"You're not going to like what I'm going to say," Therapist 3.0 dropped on me shortly before she went on vacation.
She was recommending that I think about going to a treatment center, because there were concerns, and she described recovery as being a full-time job.
Which. Um, no. For myriad reasons, but also largely for economic reasons. Because I am not made of money, and I'm going through this world without a partner providing financial backup (and, really, at this point, because I'm also not FMLA eligible for another four months). I have good insurance and a good job, but there is no money tree in the garden, and I quite literally cannot afford this hit on my finances.
It doesn't matter what her justification (or anyone's justification) might be. The stark reality of the situation is that I literally cannot afford anything that has me leaving work (even on a leave of absence) for an extended time.
Which made me wonder. How on earth do people afford it all? Is this why eating issues are largely perceived as a Caucasian upper class problem? (And, it also made me wonder about how really, this would have been so much easier during that summer I was unemployed when a psychologist I saw strongly recommended inpatient. I had horrible insurance, but at least I had no financial obligations.)
That question reminded me of a link that someone in a Facebook group I read posted about the new Netflix series "To the Bone." (FWIW, no, I'm not watching it. Therapist 3.0 and I agreed that it likely wouldn't be the best idea, and instead, I'm waiting to see what other people think of it, and what she thinks of it if and when she sees it.)
One of the points that the article brought up in criticism of the series was the affordability factor -- largely, that dealing and treating this is expensive. Apparently the series makes it seem like this is all accessible, and the burden comes down on the patient for wanting to make it work.
But you know what? That's not the case.
Fun example time: I have good insurance and a fantastic job that pays me well, all things considering -- although I came to this job after almost a decade of being woefully underpaid. Supposedly, said insurance would cover 10 percent of a short-term (so less than 30 days ... ignoring the fact that the average residential length of stay is between 30 and 90) stay. OK, that's fine. I'd hit my out of pocket max pretty quickly.
But then, you have a situation where for an adult, or a young adult/someone living on their own who is working, you're supposed to magically make do without a salary. Sure, I've got short-term disability coverage. But the reality? That kicks in after 30 days. If you're new at a job, and you don't have 30 vacation or sick days banked, you're starting out not only dealing with that 10 percent OOP cost, but then having to make it work on whatever salary you can scrape to come in.
After the STD kicks in, it would cover 60 percent of my salary. Which. Sure, in an ideal world, I'd have the savings neatly tucked away to cover that 40 percent. But even that is to the ballpark of thousands a month, and heaven help me if a larger emergency came up. And if I don't have that emergency savings? Time to live off of credit cards and hope that all the bills get paid.
Sure, that's fantastic while dealing with a serious health issue.
Yes, I suppose if I wanted to, I could raid my IRA to cover it all. But then, the IRS will tax me, and because it's not a direct medical expense, I wouldn't be able to get the penalty waived. And then I'm in the hole come retirement.
And that's not even talking about the side economic costs that aren't direct medical expenses.
One outcomes study I read said that even people in a "normal"/healthy weight range gained weight during the course of IOP, inpatient, and other treatment programs. And inevitably, if you gain the weight to the level that they showed in the outcomes study, that involves going up a clothing size or three.
Eating disorder thoughts aside, that then means having to replace a wardrobe so that you're not dealing with clothes that you are quite literally too big to wear.
I've been through the wardrobe replacing time. The low end of the ballpark cost was in the $3,000 range. Sure, maybe I could do cheaper clothes by buying at thrift stores, but then you're compounding the issues of "nothing fits me anymore" with "I can't even afford clothes that are like the image I like to present." I have a professional job, and when you consider the number of sales and coupons that I stack, buying used clothes at a consignment store would actually be on par with waiting for sales and coupons. I can't just wear khakis and polos and figure it's all good. So then you're taking the patient, and in addition to having the weight gain, there's a situation where the clothes remain a painful and expensive situation that is either addressed shoddily, expensively (yay credit card debt), or not at all.
And I don't see how any of that is better than the current situation. Because I don't see how either having no clothes, or having so much credit card debt (because don't forget, I'm trying to then live off the credit cards while I have only 60 percent of my salary coming in) is going to improve any situation. It simply doesn't.
Talk about a load of barriers that would make anyone say, "No, this isn't worth it."
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