Saturday, December 01, 2007

A critical component to any health care reform plan: Mental Health Coverage.

I am, like everybody else, glad that the hostage situation involving a mentally ill man at Hillary Clinton's New Hampshire headquarters is over, and that it ended without any bloodshed. New Hampshire law enforcement officials did a superb job of bringing it to a peaceful resolution, and the Senator was right not to negotiate with the man, identified as Leland Eisenberg. Eisenberg had asked to speak to Clinton about the difficulty he was having with getting treatment for his mental health issues.

However, while Senator Clinton was right not to negotiate or accede to the demands of someone who was holding hostages, now that it is over we must pressure her or whoever the Democratic nominee is (and I am still supporting Bill Richardson, for the record) to include mental health in any comprehensive healthcare reform bill. The brain is an organ in the body, and it is just as susceptible to disease and dysfunction as any other organ in the body. Yet people are far more likely to get fully covered by their insurance plans for treatment for heart disease, digestive disease, bone disease or pretty much any other part of the body than they are to get fully covered for treatment for mental disease.

The health insurance industry has gone to great lengths to avoid treating mental illness with the seriousness it should be, of course for the reason that it is an easy way to cut corners. Patients who have cancer, AIDS, diabetes or other ailments can sometimes embarrass the health insurance industry by speaking out about their problems in the national or local media. Mental health patients however cannot as easily speak out if they get screwed over by their insurance providers. One reason is because of the stigma still attached to mental illness, a second is that the glare of the spotlight and the publicity may in fact be exactly what they don't need if they are suffering from mental illness, and the third and most damning reason why they cannot speak out is because just by virtue of their having a mental illness, many people will consider them 'crazy' and won't take them seriously, including many in the media.

Yet mental illness strikes millions of Americans every year, ranging from mild depression to completely disabling conditions that destroy otherwise healthy human beings.

Now that mental illness is in fact recognized as a real illness (and it took a couple of generations just to get that far, which it did thanks to biochemistry and some tireless advocates) the health insurance industry has changed their tactics, but not their goal of trying to dodge coverage for mental health treatment. At the moment they are opposing H.R. 1424, the 'Mental Health Parity Act of 2007,' with the goal of preventing passage of a bill that will require insurance companies to cover treatment for a number of well-defined and recognized mental health disorders.

I once wrote a post about 'favors' that Arizona legislators receive from a variety of lobbyists and while researching that post I discovered that if not openly allied, the insurance industry has been getting some help with their dirty work from the Church of Scientology (a cult that opposes clinical treatment for mental health care) I wrote:

Others have been wined and dined by a group calling itself by the appealing sounding name, 'Citizens' Commission on Human Rights.' A check of the group's web site reveals something less appealing. They are affiliated with the Church of Scientology. If you don't know who the Church of Scientology is, they are the group that Tom Cruise belongs to, that was founded by former science fiction writer L. Ron Hubbard and believes in 'dianetics,' a medicine-free path to good health, and in particular to good mental health (and at a higher level to a release of untapped mental energy). That is the fundamental cornerstone of their belief system, so by necessity they also believe in all sorts of conspiracy plots, mostly involving psychiatrists and the mental health system. By forming CCHR, they have moved beyond the fringe and have tried to get their views accepted by people who make laws, not just in Arizona but around the country. In fact, this is a strange case of where big business and a loony religious cult have come together to shaft the little guy (as represented by a person who has a mental illness and needs affordable treatment that works). For a long time, health insurance companies have not reimbursed mental health providers or reimbursed them at much lower rates than other health care providers. Once their justification for doing so, that mental conditions were in general not diseases but purely were voluntary conditions or conditions which were produced by voluntary actions (such as drug or alcohol abuse), was proven false by biochemical researchers, they had to change their reasoning. In fact, the brain is just like any other organ in the body, subject to disease (as evidenced by chemical imbalance, even in otherwise healthy people) and psychiatrists (my father was one before he died fifteen years ago) are simply trained medical doctors who went to the same medical schools as other doctors, and specialized in the treatment of diseases of this organ. Because scientologists believe as an absolute truth and matter of religious conviction that mental illness is something that can be treated by their own (non-medical) methods, much like the old view of it, the insurance industry, while still taking mental illness less seriously (in terms of payment) than they do other kinds of illnesses, have been able to step back and let the religious cult do their dirty work for them. In fact, I have to wonder why CCHR has been so well funded. I know that Tom Cruise gets a pretty good paycheck and undoubtedly donates quite a bit of it, but the rate that this organization (CCHR) has grown is very suggestive that they may be getting some serious behind the scenes money, and if so.... well I can suggest a conspiracy theory just as well as they can.

Ultimately it does not matter what the justification is, while I do not agree with Mr. Eisenberg's methods, he does have a valid point that many people who need it don't get the mental health care they need. With the likelihood that the next President will include health care reform as part of his or her agenda, we must make it clear that mental health is just as important, if not more important, than making sure that we cover health problems involving other parts of the body.

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