Implications of mental health parity

By a recent law, insurance coverage should treat physical and mental health care in an equal manner.  I think that’s a good idea, but my friend Arwen T. did raise, on the record, a negative consequence.  As someone who has been treated in the past for a phobia she now has trouble getting coverage in the same way someone with a physical pre-existing condition would. 

Due to this vagaries of America’s health care “system” the standard way around that is to find employment with benefits.  But, getting good jobs are always tricky, particularly during a massive recession.  Similarly, severe pre-existing conditions will make finding a job harder.  For those who’ve recently lost jobs with there’s COBRA and depending on the state there may also be programs like I-CHIP.  Both allow methods of buying insurance that go around the employer base system and the denials common with individual accounts.  They aren’t cheap, but being without healthcare can be far more expensive.

On the whole, I think this downside is worth it.  Ultimately insurance needs to cover important needs or it’s a cruel joke.  The logical solution to these sorts of problem is to switch from an employer based system of care to a universal one which somehow the rest of the developed democracies of the world manage to provide.  Moving to universal care won’t eliminate trade-offs, but it does pool risk and make lives better by ensuring access to necessary and effective treatments.  However, while the odds for healthcare are good, we can’t forget about those negatively affected in the interim.

This gets to why the stimulus aid to states matters.  Most states have a hard time running deficits and so reinforce bad times with cuts to that hit healthcare and other vital services.  In addition top insuring funding we also have to make sure the transition goes smoothly.  Arwen’s been waiting a while on her I-CHIP app and I suspect that Illinois, along with most states, may be playing catch-up to deal with the new mandates in coverage.  I suspect some of the insurance companies are also reacting with blanket denials as a first recourse rather than looking at the gradations in pre-existing conditions. That may well change over time, but that’s little consolation in the meantime and healthcare often can’t wait.

This gets to why health care proposals are so careful to make sure people keep their existing coverage.  Transitions can be difficult and people do fall through the cracks. Improving care in the aggregate isn’t that appealing if you are afraid of losing yours.  I think a public option is a good idea, but I want people to switch to it because they think it’s superior coverage or a better deal.