On September 27, the New York Times published an article called Lacking Rules, Insurers Balk at Paying for Intensive Psychiatric Care. The author is Reed Abelson. Thanks to S. Randolph Kretchmar on Twitter for the link.
The article describes the kinds of conflicts that can occur between people with “mental illnesses” wanting “treatment,” and insurance companies who sometimes are reluctant to pay for this “treatment.”
The article is fairly balanced. It presents a number of actual cases of people who were experiencing difficulty. But it also tries to do justice to the insurance company’s position:
“The insurance executives say that the medical benefits of such treatments are not clear and that the industry is essentially being asked to write a blank check.”
“…there is often little accepted medical evidence to support the range of treatments for many mental illnesses, like schizophrenia and severe depression.”
The impact of the 2008 Mental Health Parity Act and the Affordable Care Act are discussed, and it is also reported that a number of lawsuits on these matters are pending.
My position on this issue is clear. The problems of thinking, feeling and behaving, collectively known as “mental illnesses” or “mental disorders,” are not illnesses in any meaningful sense of the term. They are not medical matters, and therefore their “treatment” should not be covered by health insurance plans.
At the present time, the insurance companies, by limiting and denying coverage, are providing an economic brake on the expansion of psychiatry. If the day arrives, however, when “mental illness” acquires true legal parity with real illnesses, this brake will come off, and we will likely see a significant increase in psychiatric activity.
The fight for parity is routinely presented as a struggle for justice and against discrimination. It is actually a struggle for further expansion of psycho-pharma activity.