Health Insurance and Drug Rehabilitation
Originally posted on Monday, February 5, 2007
As if health insurance plans weren't difficult enough to understand, with in-network and out-of-network benefits, co-pays, deductibles and lifetime maximums, the area of substance abuse is especially varied.
People looking for quality drug addiction treatment centers who do have insurance often assume that their coverage is good for any program - but this is not the case. There is no set standard for drug and alcohol rehabilitation coverage in the insurance industry.
Mental health and substance abuse advocates have been trying to get equal coverage for those ailments as physical problems - this has been dubbed "parity", but the sound of that term soon started to ring like a four-letter word in the ears of many insurance companies and businesses.
Currently the fight for adequate coverage for substance abuse and mental health is gearing up for another strong push since the left side of the isle is a little more full, only now the movement has been re-named "equity."
U.S. Reps. Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.) are hosting a series of public hearings on parity insurance coverage for addiction and mental health and say they plan to reintroduce legislation to require group health plans to cover these conditions on par with other health problems.
Kennedy and Ramstad said they will soon reintroduce the Paul Wellstone Mental Health and Addiction Equity Act, which would bar health plans with 50 or more members from setting different reimbursement, copays, deductibles and limits for mental illnesses than for physical illnesses.
There is possibly more than one argument both for and against the availability and mandating of such benefits. On one hand, people trying to overcome addiction should receive effective help, preferably by those rehabilitation centers that actually get results and help people become stably drug-free.
On the other hand, there has never been a clear-cut definition, diagnostic tool, or for that matter hard evidence for any mental illness, let alone a workable treatment. Therefore, many groups are split as to what should be covered and what shouldn't be.
Another argument is that including equal benefits for substance abuse and mental health coverage would cause and increase in costs to society, yet successful treatment reduces other burdens created by issues such as drug addiction. It is also an issue that prescription drug prices have driven premiums up, so more focus could be put on the pharmaceutical end of this than the organizational treatment side.
Recent scheduled hearings on the parity bill include Jan. 29 in Rockville, Md. More are coming, like on Feb. 10 in Los Angeles, and Feb. 17 in Vancouver, Wash. Local members of Congress who have signed onto the parity measure will coordinate the regional hearings.
Regardless of what side of the isle you are on, it is generally agreeable that people who are fortunate enough in this country to have insurance, whether paid for by themselves or their employers, should be able to get help for health-related problems. If it never gets mandated by Congress, then maybe those who want and can afford that particular coverage could use an insurance company that provides it, because they are out there.
Article by Eric Mitchell
As if health insurance plans weren't difficult enough to understand, with in-network and out-of-network benefits, co-pays, deductibles and lifetime maximums, the area of substance abuse is especially varied.
People looking for quality drug addiction treatment centers who do have insurance often assume that their coverage is good for any program - but this is not the case. There is no set standard for drug and alcohol rehabilitation coverage in the insurance industry.
Mental health and substance abuse advocates have been trying to get equal coverage for those ailments as physical problems - this has been dubbed "parity", but the sound of that term soon started to ring like a four-letter word in the ears of many insurance companies and businesses.
Currently the fight for adequate coverage for substance abuse and mental health is gearing up for another strong push since the left side of the isle is a little more full, only now the movement has been re-named "equity."
U.S. Reps. Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.) are hosting a series of public hearings on parity insurance coverage for addiction and mental health and say they plan to reintroduce legislation to require group health plans to cover these conditions on par with other health problems.
Kennedy and Ramstad said they will soon reintroduce the Paul Wellstone Mental Health and Addiction Equity Act, which would bar health plans with 50 or more members from setting different reimbursement, copays, deductibles and limits for mental illnesses than for physical illnesses.
There is possibly more than one argument both for and against the availability and mandating of such benefits. On one hand, people trying to overcome addiction should receive effective help, preferably by those rehabilitation centers that actually get results and help people become stably drug-free.
On the other hand, there has never been a clear-cut definition, diagnostic tool, or for that matter hard evidence for any mental illness, let alone a workable treatment. Therefore, many groups are split as to what should be covered and what shouldn't be.
Another argument is that including equal benefits for substance abuse and mental health coverage would cause and increase in costs to society, yet successful treatment reduces other burdens created by issues such as drug addiction. It is also an issue that prescription drug prices have driven premiums up, so more focus could be put on the pharmaceutical end of this than the organizational treatment side.
Recent scheduled hearings on the parity bill include Jan. 29 in Rockville, Md. More are coming, like on Feb. 10 in Los Angeles, and Feb. 17 in Vancouver, Wash. Local members of Congress who have signed onto the parity measure will coordinate the regional hearings.
Regardless of what side of the isle you are on, it is generally agreeable that people who are fortunate enough in this country to have insurance, whether paid for by themselves or their employers, should be able to get help for health-related problems. If it never gets mandated by Congress, then maybe those who want and can afford that particular coverage could use an insurance company that provides it, because they are out there.
Article by Eric Mitchell
Labels: political
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