The “M” word in health care

You know by now, probably, that President Obama is coming here Saturday to turn up the heat for his health care plan. And, of course, he’s speaking this evening to a joint session of Congress.

The White House has put together a well-crafted presentation about three people in need of health care, one of whom is from Wisconsin:

For many reasons, stories of people battling cancer or heart problems resonate with America. Most people accept that they could easily be in that situation. But few imagine a life of schizophrenia or other mental illness.

Access to mental health care has been mostly left out of the public debate., and

it’s not because we’ve got the greatest mental health care system in the world. While there are defenders of the health care system in America, there are few who’ll proudly defend the mental health care system here.

So, perhaps, it’s a good time to revisit this MPR series, A Bad State of Mind, about Minnesota’s mental health system, because things haven’t changed much since 2004. Unlike people with heart attacks or people with cancer, even people with health insurance get turned away when searching for help because there aren’t enough beds in mental health wards in hospitals, especially for kids in crisis. And mental health units were closed down earlier this decade because hospitals could make more money with pricier cardiac care facilities.

There are reasons this happened. Government regulations, for one, provided incentives for hospitals to close their mental health facilities.

Recent legislation provided for mental health “parity,” but as WHYY in Philadelphia reported today, that doesn’t mean people are getting it. It may be the one area where insurance companies are most dictating health care treatment. “In every hospital with every therapist office, somebody is recommending eight session, and the insurance company says, ‘No, we think six is enough,'” according to Trevor Hadley at the center for Mental Health Policy at the University of Pennsylvania.

All of this is grist for the health care debate, far more, anyway, than death panels. But people would rather not talk substantively about the problem.

Count President Obama in that group. At least in initial drafts of the speech, there is no mention of mental health. Will Rep. Charles Boustany, a heart surgeon who’s giving the GOP response, bring it up?

  • …in initial drafts of the speech, there is no mention of mental health. Will Rep. Charles Boustany, a heart surgeon who’s giving the GOP response, bring it up?

    Extremely unlikely. After all, people with untreated mental disorders are the GOP’s core constituency.


    But seriously, my personal story is one of being financially ruined by the cost of health care, especially the mental health care for a deeply troubled wife, and having the extra burdens placed on me contribute to my own diagnosis of clinical depression. The good news was the extra points for depression helped me qualify for disability faster than my own physical health problems alone, and now I can accurately call her “my crazy ex-wife” (which so many ex-husbands wish they could get away with). If I didn’t have an inappropriate sense of humor, I couldn’t have survived.

  • Heather

    Wendell, I am so sorry, and I am laughing so hard…

  • Lily

    The mere fact that we separate “Mental” health care from health care speaks to our lack of understanding of biological brain illnesses (the most severe illnesses that are brain based). This separation is evident in our schools, in our clinics, and in our health care benefits.

    With the closing of state hospitals, shortened stays in community hospitals, limited outpatient treatment options, and shrinking resources (thank you Tim Pawlenty for your Mental Health Act, whih made things much worse), is it any wonder that the most severely psychiatrically ill are served in jail, prison, or are simply homeless?

    You can’t blame just the Republicans for these issues, as the Dems also have a poor track record, especially those now seeking to close more of our State Regional treatment facilities, such as Anoka….

    We seem to have lost sight of the fact that the most severly psychiatrically ill DO need and benefit from long term treatment. Without it, the options are vastly more expensive and cruel.

  • Joanna

    I will never forget (or forgive) that the doctors had to get on the phone and scream at the insurance people in LA so that my sister, who was desperately in need of treatment, could receive the care to which she was entitled through her insurance policy. She would not be alive today if we had not all taken turns fighting with a bureacrat in another city over that.

    Just having insurance is not enough; we need to take the insurance companies out of the driver’s seat.

  • Tyler

    This post makes me wonder – yet again – why the practice of keeping people alive and well is a for-profit one.