The Bankruptcy of Mental Health Insurance Parity

by KEITH HOELLER

The symptoms of our health insurance crisis are visible to everyone. Health insurance costs have been increasing at rates into the double-digits; employers have been shifting more of the insurance costs onto employees and eliminating health insurance entirely for retirees; private health insurance is unaffordable to individuals; states have been decreasing Medicaid benefits, as well as limiting health coverage for the poor; and 44 million Americans still remain without health care insurance.

It is hard to imagine how politicians could make this situation worse. But they already have done so with the new Medicare prescription bill. While this bill will provide only paltry drug coverage for most seniors, it will guarantee megabillions for the drug companies, since it forbids the government from negotiating lower volume prices. And the cost, estimated only last Fall at $400 billion over 10 years, has already been recalculated as reaching at least $550 billion, or one-third more than the original estimate.

But there is another idea on the political horizon that will surely damage our health insurance crisis even more than this costly Medicare prescription bill: mental health insurance parity. Mental health providers and lay groups, including many who receive financial support from the drug companies, have been pushing to have government mandate equal health insurance for diagnosis and treatment of mental illness. Their argument goes like this: Since mental illnesses are real illnesses "just like any other," their treatment should be covered by health insurance just as much as other physical diseases.

But there are two significant ways in which mental illnesses are precisely NOT like other illnesses. The first is that mental illnesses are not illnesses at all. Mental health supporters have yet to produce a scintilla of scientific evidence that ANY mental illness is in fact biologically caused. Psychiatrists have not in fact conclusively proven that any mental illness is in fact a chemical imbalance of the brain (the latest in a long line of psychiatric theories).

Not surprisingly, psychiatrists have also not produced a single physical test that can detect any such mental illness. People who have been diagnosed with a mental illness have either not been physically tested or their physical tests have shown they are in fact healthy according to every bodily test known to modern medicine.

The second problem is that psychiatrists are the only medical doctors whose practice rests on the use of force on unwilling "patients." While psychiatrists regularly hospitalize mental patients and treat them against their will, no other doctors do this. And the use of force in psychiatry has been increasing, not decreasing. More people are involuntarily committed now than 50 years ago, and many released patients are forced to take psychiatric drugs for years on end.

Here in Seattle, the King County Mental Health Court routinely issues orders that force released citizens to take medications or risk losing their freedom. Indeed, our own civil commitment laws were expanded in the 1990s beyond simply "dangerous to self and others," to allow for the re-hospitalization of ex-patients who stop taking their medications.

Mental health supporters argue that mandating mental health coverage will result in little increase in insurance costs. Such an argument boggles the mind when you realize that they are mandating that insurance pay for billions of dollars of treatments they do not now cover. Either insurers will have to increase fees, or else they will have to cut coverage for regular physical diseases.

We may end up with health insurance that will not pay for the chemotherapy that might cure your terminal cancer, but it will pay for the antidepressants which they claim will alleviate your depression at the thought that you are now going to die. The idea that health insurance should pay for involuntary treatment is morally bankrupt at best.

But putting into practice the idea that you can get mental health coverage without any increase in insurance is a modern version of the "you can get something for nothing" mentality that politicians have been promising from time immemorial.

Our own state’s mental health insurance parity bill has passed the House and is now in the Senate. Passage of this bill is sure to bankrupt our health care system and erode the civil rights of every Washington state resident.

KEITH HOELLER, Editor Review of Existential Psychology Psychiatry (Seattle, WA)

 

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