Equal treatment for mental health in peril

Sep. 23rd, 2009 by Pia Christensen
Filed under: Health policy 

Phyllis Vine of MIWatch.org, a site about mental illness, writes that last year’s mental health parity legislation has run into problems. According to Vine, if federal rules for implementing the Wellstone-Domenici Mental Health Parity and Addiction Equity Act are not in place by the Oct. 3 deadline, treatment for many could be delayed or stopped.

The act requires insurers to treat mental illness the same way they do physical ailments, eliminating higher co-pays, deductibles and limits on hospital stays. Vine provides some background:

We should recall that parity was hotly debated before two bills (HR 1424 in the House, S 558 in the Senate) were folded into last year’s stimulus package. It was an initiative supported by a unique collaboration between advocates in the mental health community and those in the addiction community, with coverage extending to the self-insured and to those in Medicaid managed care. The House initiative, led by Reps. Patrick Kennedy and Jim Ramstad, wanted to base treatment criteria on the American Psychiatric Association’s Diagnostic and Statistical Manual. Insurance and business were able to determine that the Senate’s bill allow them to define “medical need.”

Vine writes that insurance companies are now trying to sabotage the law in an attempt to preserve profits. Letters from the American Benefits Council and Wellpoint Inc., sent during the public comment period, ask for exclusions of some conditions, treatments, providers and limits on the number of visits patients can make.

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Comments

One Comment on Equal treatment for mental health in peril

  1. Christine Forest, M.D. on Sat, 26th Sep 2009 9:33 am

    2. There is always going to be a conflict between the interests of the managed care companies, powerful, rich in resources and government connections, and the patients’ advocates organizations, mostly non-profit organizations. As a psychiatrist, I have had to learn very early on in my work, how to deal with the health care insurance companies in the best interest of my patients. For example, if a medication I believe my patient can strongly benefit from, is not paid for by his insurance because it is too expensive, and this is often the only reason they refuse to pay for it, I get on the phone, fill out forms, fax them and often they call me with more questions. It takes a lot of time. The idea is that if they make it difficult, the doctor will give up. The point being is: as long as health care management companies function as “insurers” they will have to find ways to pay less, regardless of any clinical reason.
    I wonder whatever happened with the “public option” in the upcoming health care law? It was suppose to help at keeping in check the health care insurance companies. And where are the laws that control this industry? Are we repeating the bitter lesson we learned from the financial sector: deregulation at all costs?

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