Recently,
the Obama administration passed the Mental Health Parity and
Addiction Equity Act (MHPAE) which will be implemented in the
Affordable Care Act. The MHPAE will enforce regulations on insurance
companies that require more equity in their mental health care
policies. In other words, the maximum amount of mental health coverage can be no less than the maximum amount of physical health coverage in any given year (Wolf, 2013). This means that mental illness sufferers will not have to
pay as many out of pocket expenses for the therapies they
need. Although, this is a great advancement in health care, it is just a
step in the right direction at best. There are still many things that
need to be addressed.
| Trying to find the right medication to treat mental illness can be costly. |
The
movement of making mental health coverage equal to physical health
coverage is definitely better than how it was in the past,
however, it is not ideal (Brauser, 2013). There are some holes in the Mental Health Parity and Addiction Equity act. For example, the MHPAE currently does not apply to medicaid. According to Brauser (2013), "medicaid is the largest insurer for people with mental health problems." What good is the act if it doesn't benefit the majority of people with mental health problems? Although, there is talk about Medicaid being included in the MHPAE in the future (Brauser, 2013). Another hole in the MHPAE is the fact that mental illness and physical illness are very different from each other. Providing the same type of coverage to two different types of illnesses seems less than ideal. Unlike most physical illnesses, a mental illness
typically lasts a lifetime. Chronic physical illnesses generally
present themselves in older individuals, whereas chronic mental
illnesses tend to surface in adolescence and young adulthood. Because mental illnesses present in early adulthood, quality healthcare coverage is often prevented because the mental disability makes it difficult to get a job that provides adequate health insurance. Another difference is that treatments for mental illnesses vary from person to person
and often require experimentation with different combinations and
dosages of medications in order to find a treatment that works. This can exhaust the maximum amount of coverage one can have in a given year rather quickly. On the other
hand, treatments of physical illnesses are usually consistent from
person to person and are supported by extensive research, which translates to cheaper medical treatments After
looking at how these two types of illnesses differ from each
other, it is clear that simply adding parity between the two types of
health care coverage does not suffice.
It's great that Obama is finally mandating that insurance companies actually follow this law now, but it's disappointing that this Act was signed into law in 2008 and is just now being implemented. There are some good things in the Act, for example requiring that substance abuse be covered by insurance, but I agree with Charlie that a lot more work must be done to make this Act better.
ReplyDeleteGreat post Charlie. The premise of discrimination, such as the social and financial discrimination you described, impacts those with mental illnesses greatly. This topic relates to my clinical at a center for children with physical and mental disabilities. The many forms of discrimination that apply to both individuals with mental illness and physical disabilities is disheartening. However, there is legislation that is present to counteract some of this discrimination as you also pointed out. Additionally, the Americans with Disabilities Act (ADA) of 1990 is another piece of legislation to decrease discrimination against those with physical and mental disabilities. Hopefully reforms can be made to decrease discrimination and enhance insurance coverage for those who have disabilities.
ReplyDeleteCharlie this is an excellent post that highlights so many of the difficulties that those suffering from a mental illness face. The inequality and discrimination is sadly so pervasive. I appreciate how you detailed the important effects that this Act could have in helping to eliminate some of the disparities, but it is still important to see how many disparities still exist. Working to eliminate these forms of discrimination is an important task and I believe healthcare workers need to be a part of this task force in order to ensure that the public can gain a better understanding of mental illness because it is likely that much of the discrimination could be caused by a lack of knowledge.
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