NCPA - National Center for Policy Analysis

Mental Health Parity Mandates Are Over Priced Band-Aid

August 11, 2015

Policies that aim to prevent mass violence have found broad bipartisan support in Congress. One competing bill mandates parity in mental health care. This approach has been done before; mental healthcare parity is required under the Affordable Care Act and earlier laws. Prior to Obamacare, President Bush and President Clinton both strengthened mental health parity, says senior fellow Devon Herrick of the National Center for Policy Analysis.

Recent episodes of mass violence have raised awareness of severe mental illness, and although perpetrators of these crimes undoubtedly suffer from mental health problems, it's doubtful that additional mandates will get them the treatment they needed.

A major problem with mental health parity mandates is that mental conditions are subjective.  Insurers rely upon patients' subjective descriptions and therapists' subjective progress reports.  Psychotherapists believe even mentally healthy people benefit from periodic counseling. A counselors' desire to get paid creates moral hazard and ambiguity of treatment progress that increases mental health treatment costs.

Mental health mandates are also open to fraud. Texas and Florida suffered a series of fraud accusations when patients with questionable mental health needs were admitted to for-profit, psychiatric hospitals. Patients\' health plans were then looted; only to be discharged the day their benefits ran out.

Not all mental health treatments are in response to a mental disorder.  Some patients viewed sessions like a therapeutic massage for their emotions: pleasant, but not something they would consider worthwhile if required to pay out of pocket. A generous mental health mandate would provide costly -- medically unnecessary -- gripe sessions for the moderately unhappy.

We must discuss methods for preventing future violence committed by people with severe mental illness.  Although their conditions warrant care, it's likely mental health parity mandates will do more to overtreat the affluent than help those truly in need.  Let's not pretend this over-priced Band-Aid would prevent mass shootings.

Source: Devon Herrick, "Congress' Mental Health Mandate Debate is Déjà Voodoo Economics All Over Again," Townhall, August 7, 2015.


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