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?