Legislative Pathos, Ethos, and Logos

As many of you may know I've been going to therapy for nearly a year now.  Generally for therapy to have a meaningful effect one should go weekly, but insurance companies usually impose an arbitrarily determined maximum number of visits for which they would contribute per year.  Often it's thirty sessions, or about seven months worth.  For me it was twenty sessions.  From the insurance company's point of view the mission of mental health professionals is to get a patient to be nominally functional to the point where they are not harmful to themselves or others.

The problem with this viewpoint betrays a complete lack of understanding of the job of the mental health professional.  It's not the same as breaking one's arm, it's built around the interplay that develops between the doctor and patient.  That requires continuity of care.  To use the insurance company's model, if such a doctor is out of network then they may consider allowing the patient to see him/her until they pass the threshold of no longer being harmful to themselves or others before requiring that said patient find someone in-network for more long-term care.

Were this simply a broken arm that would be fine.  But so much depends on compatibility and continuity of care.  To limit someone's search for the right therapist to those that are in-network reduces the chances of finding the help this person needs.

So, to solve some of these issues Congress is working on something called Mental Health Parity.  It was a bill that was working its way through the House and Senate last year, but was recently included in a tax package in a recent Senate session.  The press release can be found here.

It would reduce copays for mental health and substance abuse care while eliminating the maximum number of visits per year.  The number of visits an insurance company would be determined on a need basis instead of some arbitrary number.  Insurance companies may still find loopholes or be argumentative regarding determining the number of visits, but this is a step in the right direction.

The reason for the inequity in care is the stigma related to behavioral health and substance abuse care, this bill has been promoted as a civil rights issue as suggested in this New York Times article from March 6, 2008.  Mental healthcare is not luxury, it should be treated as an essential component of one's health maintenance.  If there are health insurance benefits for going to the gym, surely there should be more benefits for taking care of one's mental health.

I understand there may be a phone-in day for this bill soon.  When I find out about it I'll surely post more information here.