5.0 What They Say:
Psychiatric treatments are cost effective and “every dollar
spent on mental health care reduces other medical costs by
5 to 80 cents.”26
5.1 What They Don’t Say:
The costs of mental health care are staggeringly 150% to
300% higher than other health care services. A 1997 study
published by the prestigious Employee Benefit Research Institute,
stated, “Employers are finding the costs of an episode of
mental health care to be two to three times the cost of an
episode of care for other types of ailments.”27
When insurance coverage for mental health care began in
the 1950s, coverage was comparable to that for general medical
services. Aetna and Blue Cross/Blue Shield insurance companies
offered generous coverage for mental health services. However,
they found that while their total health care expenditures
tripled between 1966 and 1975, mental health care expenditures
increased by over six times.28
According to a recent study by the Health Enhance Research
Organization, a consortium of employers, “depressed” employees
incurred 70% more medical costs, while those reporting high
stress had 46% higher medical costs than employees without
such problems.29
A 1999 study by Dr. Gail Jensen and Dr. Michael Morrisey
showed that chemical dependency treatment coverage increases
insurance premiums by 9% on average; coverage for psychiatric
hospital stays increases premiums by 12%.30
Dr. Mark Schiller, psychiatrist, states that “historically,
psychiatric and substance abuse facilities quickly appear
to take advantage of new insurance reimbursement sources.
These facilities go on to promote their services extensively,
leading to further increases in expenditures and ultimately
higher insurance premiums.”31[Emphasis
added]
Consider also that one of the primary treatments and costs
under mental health coverage is psychiatric drugs that do
not cure and frequently can mask real and undiagnosed physical
problems an individual has. Texas, for example, now spends
more money on medication to treat mental illness for low-income
residents than on any other type of prescription drug. Those
costs have more than doubled since 1996, when mental health
medications were the third largest category of expenditures.
In 1999, these drugs made up the largest category of expenditures
among the top 200 drugs, accounting for $148 million; $37
million was spent on three of the newer antidepressants
and $57 million on three anti-psychotic drugs alone. The
rising costs in this and Medicaid expenses have put a squeeze
on the state budget.32
While Oregon to date doesn’t have mandated mental health
coverage, in 1994, it added 100,000 uninsured people to the
Medicaid program by placing limits on the Medicaid benefit
package—more people were covered, but for fewer services.33
The Oregon Health Plan (OHP) covers mental health and substance
abuse treatment. This alone led to a substantial increase
in prescriptions for psychiatric drugs, where dosages were
higher than recommended.
So dramatic was that in January 1998, the Department of
Human Resources proposed a plan to supervise prescriptions
funded by OHP with the view to saving taxpayers $700,000 annually.34
With Medicaid, the misuse and over-prescription of psychiatric
drugs became prevalent: The OHP now spends $6 million a year
on just one antidepressant. In 1997, the manufacturer of this
drug spent $30 million on direct to-consumer marketing of
psychiatric drugs.35
Wherever leverage is given to mental health services, increased
costs follow because of the mental health industry’s reliance
on psychiatric drugs, rather than addressing or curing the
problem the drugs are prescribed for.
The Wall Street Journal reported on October 5, 2001,
“Mental health is already a big expense for employers. Brand-name
antidepressants have been among the most commonly prescribed
medicines that companies pay for, and prescriptions are certain
to rise as a result of the attacks.”36
Already, since the September 11 attacks, new prescriptions
for anti-anxiety drugs rose 25% and for antidepressants it
jumped 17% in New York alone.
Spending on drugs generally is rising at three times or
more the rate of inflation.37
6.0 What They Say:
The role of private insurance is critical to servicing
all traumatized Americans and mental health parity is urgent
to address the insurance needs and mental health services
necessary to combat the psychological trauma from terrorism.
6.1 What They Don’t Say:
More than adequate funding has already been released from
existing sources. Health and Human Services has released $6.8
million for crisis mental health and $21 million to supplement
existing mental health systems already in place. Up to 2.5%
of the Substance Abuse Mental Health Services Act funds for
local communities experiencing mental health emergencies was
released.38
The Federal Emergency Management Agency (FEMA) has released
$22.7 million and has promised more funds.39
The mental health industry has a record of greed when it
comes to spending on disaster funds, primarily intended for
the relief of physical and financial suffering. Of the $4.6
million donated after the Columbine High School shootings
in 1999, $775,000 was given to Jefferson Center for Mental
Health and $425,000 went to pay for 9 full time counselors
for Columbine and its feeder schools, while the families of
the slain victims received $50,000 each.
Families of the physically injured were given $10,000 each.40
The counselors received the same amount as the families who
lost their loved ones.
In 1999, a San Diego psychologist, Dr. Michael Mantell,
reported that following the Columbine High School shootings,
“the kids were not talking to counselors. They were talking
to religious leaders and among themselves. There were a lot
more counselors there than counseling going on.”41
In the wake of the current terrorist attacks, a New York
Times article reported that even most school children in New
York City have resisted psychological counselors’ attention.
“The students are saying, ‘Can’t we just do math?,’” according
to Dr. Ricky Greenwald from Mt. Sinai Hospital’s Child Trauma
Program.42
The mental health lobby has gushed that 71% of Americans
felt depressed from the attacks. Alarming enough statistics,
until it is realized that the survey behind this statistic
was conducted just two to six days after the attack, when
the majority of Americans were still in a state of shock,
glued to their television sets and suffering perfectly normal
reactions to the horrific tragedy. Who needed a survey to
find out that Americans were suffering? The survey sampled
1,200 people, which, by a quantum semantic leap, concluded
that an alarming 71% of Americans have been harmed.43
Similarly, a U.S. Senate hearing on trauma and terrorism
held on September 26, was told that nearly 50% of individuals
in the path of the 1995 Oklahoma bombing developed a psychiatric
disorder, usually post traumatic stress disorder (PTSD) and,
secondarily, major depression. However, only 182 of the 1,098
survivors of the bombing who registered their names with the
Oklahoma State Department of Health, were interviewed; 45%
of these—or 81 people—reportedly had psychiatric problems
in the six months following the bombing, with 34% (27) reportedly
having PTSD.44 The president of
the National Mental Health Association—a man who is funded
by pharmaceutical interests—claimed that the country now needs
“a complete mental health infrastructure.”
Yet psychiatrist Sally Satel in The Wall Street Journal
warned against his comment and the “sensationalizing mental
health professionals” spreading gloom and doom about the American
people’s seeming lack of resilience, stating, “What we need—and
thankfully seem to have—is a morally galvanized and focused
citizenry, not a population turned inward on its alleged psychological
fragility.”45
Next: Mental Health Parity Analysis continued
|
