All of us have had experience with health insurance, or lack of it, for regular procedures and common acute care situations. But what about mental health insurance? Over 90% of the population never use their mental health coverage, but for the 5 to 10% of the population with severe and persistent mental disorders, there are two tragedies- the tragedy of the illness, and the economic devastation these illnesses bring. Parents are sometimes forced to give up parental rights to get kids the care they need, because long-term care is only available for kids in state custody here in FL.
Many insurance plans treat mental illness as an afterthought, with annual and lifetime caps on benefits which deny services to those who need it most. Mental health parity is a concept which states that mental health care coverage should be equal to physical health care coverage, and it's still an unobtainable goal for many Americans. So, whose health care program will best help these desperate people, Barack Obama's or Hillary Clinton's?
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Current Situation with Mental Health Parity
Many health insurance plans discriminate against people with mental illnesses by limiting mental health and substance abuse health care. Some of the ways this is done are by imposing lower day and visit limits, higher co-payments and deductibles, and lower annual and lifetime spending caps.
State laws are a hodgepodge of different definitions of mental health parity, and only about two-thirds of the states have passed any law at all. On the national level, Congress passed the Mental Health Parity Act in 1996, but that law is misnamed, as was the one which passed last month. Both outlawed annual and lifetime dollar insurance limits for mental health care, but they also allow all kinds of restrictions, such as only applying to companies with greater than 50 employees. Many employers and insurers violate the spirit of the law, however, by placing other restrictions on mental health benefits, such as limits on the number of covered outpatient office visits and number of days for inpatient care- say, 30 days maximum per year, combined outpatient and inpatient treatment. When your benefits max out, you "magically" get better and are discharged.
No progress has been made on closing these loopholes since the law was passed, despite broad bipartisan (verbal) support. President Bush was big on verbal support back in 2002, but has been mysteriously silent since then, finding other hobbies to occupy himself. Congress had re-upped the 1996 law using a series of one-year extensions, since there was no desire to thwart the president's foot-dragging when Republicans had power, and little improvement under the Democratic Congress in the last two years until the recent legislation. Like the rest of health care, mental health parity was just one more ugly baby nobody wanted to adopt.
Barack Obama's Plan
Here is the most detailed version of Barack Obama's health care plan, from his website:
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The plan will have the following features: Guaranteed eligibility. No American will be turned away because of illness or pre-existing conditions. Comprehensive benefits. The benefit package will be similar to that offered through the Federal Employees Health Benefits Program (FEHBP), the program through which Members of Congress get their own health care. The new public plan will include coverage of all essential medical services, including preventive, maternity and mental health care. Coverage will include disease management programs, self management training and care coordination for appropriate individuals. |
Same old same old. "Essential" services are covered, just like insurance coverage today. No mention of mental health parity.
Hillary Clinton's Plan
Again, here is the most detailed version of Hillary Clinton's health care plan, from her website:
A Choice of Health Plan Options: Businesses, employees, and the uninsured will have the option of buying group insurance through a new Health Choices Menu. This Menu will give all Americans the same set of insurance options that their Member of Congress has. Without creating new bureaucracy, the Menu will be part of the Federal Employee Health Benefit Program (FEHBP), which includes numerous, high-quality private health insurance options. The Health Choices Menu will have the purchasing power of millions of Americans in securing high-quality and affordable insurance. States will also have the option of banding together to offer the same type of choices in a region of the country if they wish. The benefits will be as good as those offered to Members of Congress. Such coverage includes mental health parity, and many plans offer dental coverage. In addition, as a condition of doing business with the federal government, insurers must cover high priority preventive services that experts agree are proven and effective. This focus on prevention will improve health and lower costs in the long run. |
Well, there you have it, folks. Hillary Clinton said the magic word- mental health parity. Her plan isn't "similar to" the Federal Employee Health Benefit Program (FEHBP), as Barack Obama would have it, it IS the FEHBP. It's not "based upon Medicare", it's the exact same plan the Congresscritters are so happy about.
When the evidence in these plans is examined, it's clear that only Hillary Clinton has made the commitment to provide adequate mental health care for the approximately 60 million Americans who need it.
But plans are just paper, and whomever ends up with the nomination still has plenty of time to do the right thing and help these, the least powerful people in our society.
p.s. Hillary's plan is also the only one which mentions dental, too, albeit with the "many" qualifier attached.
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