Body Brokers: The business of making billions out of drug addiction
Written and directed by John Swab
Barack Obama’s Affordable Care Act (ACA) of 2010 required health care providers to cover substance abuse treatment. Body Brokers, a fiction film written and directed by John Swab, deals with how the act spawned a predatory business of drug treatment that allowed rehab centers to scam the federal government and insurance companies out of millions of dollars. This is one of the disastrous side-effects of health care for profit.
The film opens with narrator/actor Frank Grillo listing a hair-raising statistical reality. Since Obamacare was passed, nearly 2,000 “sober living” houses, 100 in-patient treatment centers and 200 detox facilities have opened up in Southern California alone. That is nearly 35,000 beds that need to be filled each month, and almost 500,000 that need to be filled annually, bringing a profit to private companies of some $12 billion annually—again, just in Southern California.
Market Research gloated in 2020 that “Drug and alcohol addiction rehab in the United States is big business—worth $42 billion this year. There are now 15,000+ private treatment facilities and growing.”
Body Brokers’ storyline follows Utah (Jack Kilmer, son of actors Val Kilmer and Joanne Whalley) and Opal (Alice Englert), two heroin/cocaine addicts in Ohio, committing robberies to sustain their habits. These are two sensitive young people whose lives are spiraling downward. A chance encounter with Wood (the immensely talented Michael K. Williams—who last September tragically succumbed to acute drug intoxication) gets Utah into a Los Angeles drug treatment center. Utah soon learns that the rehab facility is actually a cover for a fraudulent multi-billion-dollar operation and that Wood functions as a “broker” on behalf of the facility.
Melissa Leo plays Dr. White, the rehab’s therapist, and Grillo is its owner Vin, whose slick, mendacious pep talks hide a homicidal personality. After 90 days in treatment, Utah becomes Wood’s sidekick, making a small fortune enlisting addicts whose stay at the center is funded by insurance companies or government agencies. He soon learns that the system has no incentive to cure addiction, but rather to create repeat business. Like Wood, Utah begins “brokering bodies” as referrals to the facility.
Wood introduces his protégé to a call center that bids for patients. Earnings are generated based on leads, with agents posing as caregivers who auction off the desperate patient to the treatment center paying the highest commission.
As the Recovery Research Institute explains: “Under the guise of free insurance or care, patients, sometimes multiple at a time, are enrolled in insurance plans utilizing false addresses to take advantage of the ‘change in address’ exception, which allows for year-round insurance enrollment. Patients are often unknowingly signed up for premium plans with generous coverage (e.g., out-of-network coverage and low out-of-pocket costs) available in states that the patient does not live in, nor has ever lived in, but serve to reimburse the ultimate treatment center at a higher rate than other plans or providers.”
The website points to the “common practice of a patient’s health information, such as their treatment plan or diagnosis,” being discussed “in a sales or marketing context, and shared with individuals outside the patient’s care team, without medical necessity or the patient’s consent. This is in violation of HIPAA [Health Insurance Portability and Accountability Act of 1996] and other patient privacy protection laws that work to protect sensitive health information of the individual.”
Body Brokers calls this the “rehab shuffle.” It details the various steps in the process—Phase 1: $4,000 for detox; Phase 2: An average 60-day residential stay at $2,000 per day; Phase 3: Outpatient at $2,500 per day. A 90-day program totals $300,000 per person. This is what Wood terms “the American F—— Dream.”
Crazy-eyed junkie Sid (Owen Campbell), a chronic rehab shuffler, who gets $2,000 per referral, is described by Wood “as a living, breathing ATM machine—that’s the type you have to keep close—you can’t let them get away … he’s not getting better anytime soon … after 90 days he hits the streets and comes back for another 90 days.”
Doctors are also part of the scam. Naltrexone implants, used to treat opioid-use disorder, are billed at $60,000 per implant. Dr. Riner (Peter Greene) can do 20 implants a day, raking in $1,200,000. However, Riner comes to a bad end trying to increase his split at Wood’s expense.
Director Swab, who explains that he was “a street junkie for over a decade,” went through countless rehab and detox centers all over the country, was brokered and learned how to broker bodies. Swab explains in an interview with the Observer: “I had been in all kinds of rehabs and had seen it all, with about an aggregate of two and a half years in residential treatment.” It is such an intractable problem that the families of addicts are “not thinking about the treatment centers’ incentive, which isn’t to get somebody well, it’s to keep them there as long as they can and milk them for all the money that insurance will pay out. Because of a lack of regulations, laws and oversight, the treatment facilities have been able to operate in the grey, where it’s not necessarily illegal what they’re doing.”
The filmmaker further asserts that “many of these addiction centers are publicly traded companies that are involved in body brokering. It’s really murky to know who the villain is. Even the people doing the body brokering, they were addicts trying to get home, and at some point were taught how to do this. It’s tough to point your finger at any one place or person and say they’re in the wrong; it’s a really messy situation.” In other words, the root of the problem lies in the overall economic structure of society, not the actions of this or that individual or institution.
In a March 2021 interview with Collider, the late Michael K. Williams explained that before reading the script for Body Brokers, he had been “completely ignorant” about “the capitalistic mentality that exists in the rehabilitation centers for recovery. I was a bit taken back and like, ‘Wow, when you look up taking advantage of someone when they’re vulnerable, this storyline is the poster child for that,’ in my opinion. … From the outside looking in, most people in the world of recovery believe that, once people put down the drug, everything should go back to being hunky-dory, but that couldn’t be further from the truth. The drug is not the problem. The drug is merely a symptom of the problem.”
Body Brokers ends by explaining: “While you watched this film, 15 people died of drug overdose. In the last 20 years in the US alone, nearly 900,000 drug overdose deaths. That’s more than the US casualties of WWI, WWII, the Korean War, the Vietnam War and the War on Terror combined.”
“This is a film about where capitalism fails addicts,” Swab comments. Of course, mass drug addiction is already an expression of capitalism’s massive failure and growing crisis. In any case, Body Brokers shines a light on one of its many graveyards.