WHEN THE CURE IS NOT WORTH THE COST
April 12, 2007
On its face, providing equal coverage for mental and physical illnesses sounds like a good idea, something only a managed-care bean counter could oppose, says Maia Szalavitz, a senior fellow with Stats, a media watchdog group.
To that end, Reps. Jim Ramstad (R-Minn.), and Patrick Kennedy (D-R.I.), have introduced the "Paul Wellstone Mental Health and Addiction Equity Act."
- Named for the senator who was long an advocate for mental health "parity," the bill would require that private insurers pay for as much treatment for mental illnesses and addiction as they do for physical illnesses.
- Unfortunately, this change would not be as benign as it appears; unless mental health parity is tied to evidence-based treatment and positive outcomes, generous benefits may become a profit bonanza for providers that does little to help patients.
Thanks to research by the National Institutes of Health and academic scientists during the last three decades, we now have proven treatments for depression, addiction and other mental disorders. But all too often clinicians do not use them.
Without financial incentives to provide treatments that are known to work, explains Szalavitz, many mental health professionals stick with what they know, or pick up on the latest fad, or even introduce their own untested innovations -- which in turn are spread by testimonials and credulous news media coverage.
If we want to provide genuine help for the 33 million Americans with mental health and drug problems, giving more no-strings-attached money to providers via insurance mandates is not the answer. It is dangerous to blindly bolster useless and even harmful treatments while failing to support proven therapies. Coverage must be tied to outcomes and evidence. And payment should be dependent, at least in part, on health improvements, not just services received. We need parity in evidence-based treatment, not just in coverage, says Szalavitz.
Source: Maia Szalavitz, "When the Cure Is Not Worth the Cost," April 11, 2007.
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