July 6, 2009


This is exactly why a national single-payer health care plan (or its European equivalent) is needed. We could actually afford to treat everyone's conditions with the massive savings we'd realize if we move from a profit-driven health insurance system.

The Massachusetts plan is struggling because it's nothing more than an insurance co-op - something that keeps paying the middleman:

Tens of thousands of Massachusetts patients who grapple with some of the most intractable mental health problems - eating disorders, addictions, autism, and post-traumatic stress - should face fewer barriers to treatment under a state law that went into effect July 1. But the cost of the state’s latest healthcare expansion remains an open question.

The new law, which lifts limits on care, adds the four mental health disorders to nine other common psychiatric conditions that health insurers must cover as they do physical ailments. That means, for example, that a drug addict who previously would have been denied treatment after 24 outpatient sessions and a total of 60 days in a hospital will now get as much care as medically needed to tame an addiction.

While patient advocates hailed the expansion of mental health assistance, the people who will pay the bills - insurers and companies that provide health coverage to their workers - greeted the law with uncertainty, especially about its cost.

The expansion illustrates two of the most pressing issues in healthcare today: equality for mental health services and the price tag for expanding medical care.

“Any step we take that breaks down this artificial divide that exists between mental illness and physical health is a big step,’’ said Matt Noyes, a mental health advocate at Health Care for All, a Massachusetts consumer group.

Medical spending is under scrutiny from Beacon Hill to Capitol Hill, and the cost of expanding mental health coverage, known as “mental health parity,’’ is a matter of disagreement.

Supporters of the change, citing the experience of other states, said they expect parity will add less than 1 percent to overall healthcare costs, while easing the stigma of mental illness.

Insurers’ overall spending in Massachusetts, estimated at about $13 billion a year, will increase by $13 million to $39 million a year because of the new law, according to regulators’ calculations.

But a coalition of employer and insurance groups contends that the costs are likely to be significantly higher. Insurers said that the state’s calculations substantially underestimate the costs. They have not, however, come up with their own estimates.

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