"Better" Medicare Filled with Destructive Loopholes

Paula Span's article, Coming Soon: Better Medicare Support for Mental Health, was published September 17, 2009 in the New York Times. Span writes about the troublesome stigma that the American society attaches to mental illnesses. Both Span and mental health advocacy groups believe, "The current policy, as old as Medicare itself, treats mental illness differently from physical illness, a discrepancy that discourages elderly patients from seeking help for psychiatric problems." The good news is that by January 1st 2010, the Mental Health Parity Act will take action. This act requires both group health plans and group health insurers (Medicare) to apply the same treatment and financial limits to mental health disorder and substance abuse as they do for physical illness and surgical producers. Therefore, this act was developed to gradually change Medicare fore the better; "Medicare will gradually begin reimbursing for mental health treatment the same way it reimburses for care of cancer or kidney disease."

With this said, insurers would not be able to put a dollar amount cap on mental disorders. The once approved cap on mental disorders was discouraging patients to seek help in the first place, because they would eventually run out of coverage and fall into financial troubles. So, one would think the Mental Health Parity Act solved all and everyone suffering from a mental illness would be treated and cured some short time after January 1st, 2010, well one thought wrong.

Insurers have found a loop hole in the Mental Health Parity Act. Instead of placing a dollar cap on mental illness treatment, insurance companies created a new cap that is perfectly "legal" within the new act. Insurers are now placing a limit on the number of visits to a therapist, psychiatrists, and so forth. Furthermore, they have placed a limit on the number of days one can be treated in a hospital. In a way, this cap is negatively effecting patients just as much as the dollar cap did. For example, a teenager with an eating disorder may not seek medical treatment because she knows it would cost more than her cap would cover; therefore, she closes the door on any opportunity to get help and continues to suffer. But, even after January 1st, after the Mental Health Parity Act has been enacted, this teen will still suffer. She would still suffer because she wants and knows she needs to be checked into a hospital for medical care, but her case is so severe she will out use the number of days her insurance will cover, leaving her with an outrageous bill to pay out of her pocket.

All and all, insurance companies are finding ways to treat mental illnesses differently and in turn, more people are suffering at unnecessary levels. Do you think the health care reform plan should consider mental illnesses to be the same as physical illnesses and how would the bill ensure that insurance companies would follow the plan?