Caitlin Owens Jan
8, 2020
America's mental health care system is in dire need of an
overhaul, but the any real specifics are largely missing from the 2020 debate
about health care.
Why it matters: Suicide and drug overdose rates
continue to rise, and the U.S. faces a shortage of mental health providers and
a lack of access to treatment.
The big picture: Private insurance is plagued with
holes in mental health coverage. Even even though insurers are legally required
to cover behavioral health the same way as physical health, they don't.
Yes, but: Medicare to All may not solve the
problem, Mental Health America president and CEO Paul Gionfriddo told me.
- “Medicare would need to
be redesigned significantly," he said.
- Medicare has its own
coverage flaws. It would also be crucial to design a system that
encourages preventive and early identification services rather than just
post-crisis care.
There's also a shortage of mental-health providers.
Paying mental health providers more could help address this, but care delivery
would also need to be redesigned, Gionfriddo said.
- Rural areas,
for example, would likely still struggle to attract and support these
providers because of their remoteness and population size.
- "The big wild card
is how many mental health providers would participate in a Medicare for
all program or opt out of insurance entirely," said the Kaiser Family
Foundation's Larry Levitt.
For Democrats who support Medicare for All,
highlighting how it could help mental health care could have a political
upside.
- “Talking about mental
health care needs humanizes the candidates, indicts the shortcomings of
private insurance and provides rationale for the need for significant
reforms around the current system," Democratic health consultant
Chris Jennings said.
The bottom line: "We have a huge problem with
health insurance for mental health. A major reform could be an opportunity to
improve mental health services, but it could also do harm to them,"
Gionfriddo said.
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