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ObamaCare Clusterfuck: Children's mental health

A reader writes:

You could add this story to your Obamacare clusterfuck series. My insurance runs out in a week. I've been on COBRA for 18 months. In the last three months, my child has been hospitalized three times for mental health issues. The diagnosis is fluid but at the bottom of it there is a form of bipolar disorder with some psychosis. The doctors don't label kids at that age because so many things overlap and resolve and it's just too difficult to say where all of this is going but the prognosis is good. But they will need at least 6 more months of out patient treatment. The cost of a partial program is about $900/day. For intensive outpatient programs (3 days a week for 2 hours a day) it's about $500/day.

When the insurance runs out, I'll be expected to pay this. I've been searching online and over the phone for individual policies that cover mental health. Guess what? There are very, very few of them. That's because unless you live in Ohio, insurance companies do not have to offer mental health coverage to individual policy holders.

Yes, there is CHIP. I filled out an application for my state and their dad is waiting for confirmation in his state. But we don't know the status of that yet.

There is charity care. They will weigh my assets against any costs that theyt incurs. In other words, there goes the college fund. Medicaid is also an option but in that case, they will get a gigantic "DISABLED" label that will follow them around as long as they needs treatment. It will look great on the transcripts.

This is how we treat our kids.

It is. But it's not how we treat our insurance companies, is it?

There are at least two reasons children's mental health is yet another ObamaCare ClusterFuck: Weak, slow implementation, and screwed up eligibility. (That is, children's mental health has the same two problems every other ObamaCare program has.)

Weak, slow implementation. Consider the "health home" program:

Aided by the health care law, some states have already put in place a model that creates a dramatically different way of caring for Medicaid mental health patients. But if the slow state uptake of the program is any indication, the patterns of spotty care for most low-income people with big mental health problems won’t change quickly.

The idea is a “health home” for the mentally ill, a way of integrating behavioral health and primary care. Health homes aren’t actual physical places. They’re care systems that provide an individual with a chronic condition — such as a mental illness — with a team of caregivers who can coordinate and communicate. Funded by the health law, the goal is to provide comprehensive treatment, known as “whole person” care.

Plenty of states have shown interest in adapting the medical home for mental illness. But while funding through the health law has been available for about two years, just 10 states have health home initiatives approved by the Centers for Medicare & Medicaid Services, according to CMS spokesman Alper Ozinal.

And just six — Missouri, Rhode Island, New York, Oregon, Ohio and Idaho — target those with serious and persistent mental illnesses or substance abuse disorders, Ozinal said.

Screwed up eligibility:

Today, 52 percent of uninsured Americans say the main reason they don't have insurance is because they can't afford it. Unless the ACA changes this situation, it cannot succeed. Astoundingly -- since it is in direct conflict with the central goal of the ACA -- the Internal Revenue Service recently issued a ruling on how subsidy levels will be determined. Their ruling poses a huge affordability problem for families with children. It says that subsidies for families will be based solely on whether the individual employee's coverage is affordable; if it is, the whole family is ineligible for subsidies, even where the employer's family coverage is unaffordable. As a result, nearly half of a million children across the country are expected to remain uninsured because parents would not be able to afford coverage for the whole family. The impact must be analyzed in 2014, and remedies must be found.

Well, I'm glad that in 2014 Obama's going look at the problem, and find some remedy that doesn't involve drone strikes or speeches. Meanwhile, this kid needs help now.

It's worth remembering that if single payer "Medicare for All" had been passed in 2010, every American, including this child, would have been covered for two years already. When LBJ set Medicare up in 1965, in the days before computers, it only took a year to implement. That's because single payer is simple. ObamaCare, by contrast, is incredibly complex. And the complexity comes directly from a single decision by Obama: To bail out the insurance companies and put them at the center of the system permanently. Remember, under The Sachs Conjecture, the top 1% are sociopaths: They care only about the rents that the health insurance industry brings in, and that profit comes from denying care, not providing it. They do not care about health care for you or your children or your family in the slightest degree. That's because they can buy whatever they want. ObamaCare, because these guys own Obama, was written to make them happy, not us, and it shows.

Average: 5 (2 votes)


katiebird's picture
Submitted by katiebird on

The cruelty behind each step of the development of the ACA is frightening. So coldly calculating.

Reader, I wish there was something we could do. There must be something. .... Occupy the ACA?

I am so sorry.

katiebird's picture
Submitted by katiebird on

I have never understood why Mental, Dental & Optical health are separated like they are special treats and not life necessities. I really thought the ACA had brought Mental Health to an equal level with physical (how do you separate these things?) health. And (silly me) that it took affect at the same time as letting people keep adult children on their health care plans.

apishapa's picture
Submitted by apishapa on

My grandson is on Medicaid and I'm glad he has it. Otherwise he wouldn't have any insurance at all. My son turns 26 next month and will have to be taken off my insurance. He is highly allergic to bee and wasp stings, and wasps are everywhere. I don't know what he will do if he gets stung again this year.

Several years back, I had to drop my insurance. I was paying $400/month for high risk insurance with a $1500/person deductible. By the time anything got paid by the insurance company, I was out $10000/year. My family is really healthy, so I saved a couple hundred dollars a month, and hoped nothing bad happened. Though at the time I met the income standards, as a state employee I was ineligible for CHIP. This was while they were in high school and playing sports. How do you tell a kid, yeah you can play football, but don't you dare get hurt. Of course he did.

I would gladly pay more taxes to get single payer, but Medicaid is better than nothing to those who have no other choice. I do understand the concern about labeling. My son was diagnosed with ADHD. He wanted to join the Army, but he can't because of that. That is just stupid, but a whole nother rant.

Submitted by lambert on

Cutting out the middleman saves at least $400 billion a year (and if you calculate by GDP, IIRC, as letsgetitone did) it saves more. That's enough to cover everybody who doesn't have heath insurance now.

World wide, every single payer system is cheaper than ours.