Insurance Policies Often Set Up Patients to Fail
Dennis Romboy and Lucinda Dillon Kinkead’s article, “Struggle for control: Mental-health care coverage is lacking” gives us a glimpse of how our view of mental illness as “something different from physical illness” spills over to our healthcare system.
For insurance companies, coverage policies give mixed signals to patients. Often, that signal is, “You’d get coverage if you were catatonic and completely non-functional, but if you’re trying to function and live a normal life - well - good luck.”
A high number of suicides occur in patients suffering from a mental illness but were not receiving treatment. Sometimes, the insurance policies can set up a dangerous situation to happen because it forces doctors to play a numbers game with patients so that the patient can continue to get coverage.
I remember when I was undergoing treatment, my doctors had to play the same game to help me get insurance coverage. At the time I was a starving grad student and couldn’t afford therapy if insurance didn’t cover it. My psychologist offered to cut her rate so that I didn’t have to pay too much out of pocket. I was making progress and she didn’t want me to fall by the wayside.
However, the game was “You need to get well, so the insurance company could see progress and continue to cover you. But you can’t get too well, because insurance companies would see no point in continuing to cover you.”
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[...] Insurance Policies Often Set Up Patients to Fail [...]
Another way insurance companies set patients up to fail is by making the process of finding covered providers impossible for people with some mental illnesses. If you suffer from depression severe enough to make concentration difficult, severe enough to ruin the motivation and optimism necessary for perseverance, it can be impossible to navigate some companies’ byzantine systems for finding an appropriate provider who is covered.