While doctor and politician Howard Dean believes it’s better to have passed the recent healthcare bill than not, he says it’s not healthcare reform…It is coverage expansion. It’s a simple concept, really. Everybody needs to put food on the table…and preferably have a table to put it on and a place to put the table. That assumes jobs and paychecks come into the mix. By guaranteeing medical coverage, payment for healthcare becomes guaranteed, healthcare providers earn a living, and people’s health problems get attention.
With healthcare payment guarantees, mental health issues become the next topic of discussion. There is resistance to comply with recent legislation assuring health and addiction treatment services getting paid on par with physical health issues. I recently discussed the battle the insurance industry is waging to escape restructuring their business to comply with Mental Health Parity. Additionally, millions of senior citizens need treatment services not likely to be paid for by Medicare, according to Dr Dean’s interview in The National Council’s Healthcare Reform Magazine It seems that Medicare has been exempted from the reforms of the healthcare bill. It appears that insurance companies and Medicare are in the same ethical boat when it comes to mental health and addictions treatment. Everybody says they want people to be well and have better lives and nobody wants to pay for it.
The place I see ethical responsibility in action is with treatment providers.
I was talking with a friend who runs a small addiction treatment facility recently, and I was stricken with his sincerity. He wants to help addicts stay off drugs and have a good life. In my experience, that’s true throughout the business. Whether you talk with helping professionals in your local community mental health center, addiction treatment facilities or social services organizations, they want to help others.
My peers write on a personal level about coping with issues, relieving symptoms of disorders and generally improving our mental health. I believe they, and most professionals in this business are sincere. They want alleviate suffering. The ability to help is slowly being improved.
The payment system for these professionals has appeared to be one to avoid paying for their services. Authorizations to provide services are dictated in many cases by insurance companies. For years I’ve heard many mental health and addictions providers say it’s murder trying to get insurance to pay for services that need to be delivered now. They took the attitude that when a person needs help, help them…not after treatment is approved by a bureaucrat for payment. These folks wound up providing free services in many cases…which doesn’t put food on the table. This leads to the most important point Dean made in the interview cited above.
Treatment decisions need to be in the hands of treatment professionals, not insurance bureaucrats, so this rebuilding of the system is necessary. It takes involvement and working within the system to rebuild the system. That’s happening now. The legislation I cite is the first step, a decision to assure payment for help that improves people’s lives with quality mental health and addictions treatment. My hope is that the professionals gain more control in healthcare decisions and are treated with the respect due a trained, experienced professional. As that happens, smart, caring, people with a sense of moral responsibility to help others will enter the helping professions, joining many others who are active in changing the system to enable treatment professionals to control treatment.
Active integration of moral responsibility into the business side of this business, my friends, will be true healthcare reform.
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