Friday, May 25, 2007

Where is Hillary on Insurance Discrimination for Mentally Ill?

I saw in today's Washington Post that Senator Hillary Clinton is developing a 7-point plan to address problems in our health care delivery system and to reduce costs:

  1. a "prevention initiative" to reduce preventable diseases such as diabetes;

  2. modernizing health-care records through computerization;

  3. overhauling care for the chronically ill, whose costs account for approximately two-thirds of all health-care expenditures;

  4. "ending insurance discrimination" by providing care to people with pre-existing conditions, who are currently shut out;

  5. creating a "best practices institute," with both government and private participants, to determine standards of care;

  6. legalizing prescription-drug importation and requiring Medicare to negotiate lower drug prices; and

  7. implementing "common sense" changes to the medical malpractice system.

I was surprised to see her mention "ending insurance discrimination" without mentioning -- in the same breath -- ending the long-standing practice of carving mental health treatment out of the rest of the medical system, while applying different payment mechanisms (higher co-pays, for example) which have resulted in fractured care systems and higher costs. Even Medicare continues to charge beneficiaries a 50% co-pay for outpatient mental health care rather than the 20% for all other organ system disease.

This "carve-out" system is the ultimate in insurance discrimination. This lack of parity between brain illness and body illness should have ended in the 1990s, during the Decade of the Brain.

So, I went to the source at I found yesterday's speech about her health care plans. Skimming it, I saw no mention of mental health care. Ctrl-F brought up the Search bar... I typed "m-e-n-t-a-l" ... no hits.

I'm sure she supports this concept (who wouldn't, other than maybe insurance companies?), but c'mon lady, give it a bullet point. Make it a campaign issue. At LEAST pay lip service to it in your speech. Millions of Americans get shafted on this issue every single day.

What will you do about it, Madam Senator?


Anonymous said...

Didn't she already have a crack at healthcare reform in 90 days? Or was that a dream I had....

Midwife with a Knife said...

I hate to be a pessimist, but I don't think anybody's REALLY interested in healthcare reform. Blah.

Zoe Brain said...

I'm going to sound obsessive again...

"I contend that the problem of transsexualism would be best served by morally mandating it out of existence." [The Transsexual Empire by Raymond, p. 178].

"The book is not the most damaging writing that Raymond has penned. Far worse is a United States federal government commissioned study in the early 1980’s on the topic of federal aid for transsexual people seeking rehabilitation and health services. This paper, not well publicized, effectively eliminated federal and some states aid for indigent and imprisoned transsexuals. It had a further impact on private health insurance which followed the federal government’s lead in disallowing services to transsexual patients for any treatment remotely related to being transsexual, including breast cancer or genital cancer, as that was deemed to be a consequence of treatment for transsexuality."

The majority of health insurance policies in the US have specific exclusions for anything to do with transsexuality: despite studies that coverage would cost each policyholder 11c a year.

"It also wasn't long before McHugh's article was exploited to support Executive Branch policy-making: On October 15, 2005 the Internal Revenue Service disallowed a woman's tax deduction for sex reassignment surgery (SRS) - citing McHugh's teachings in the Catholic religious magazine as a basis for its decision. "


Co-payments of 50% are better than 100% : especially if the costs are tax-deductable.