Mental Health Services Under The Affordable Care Act
http://thedianerehmshow.org/shows/2012-07-31/mental-health-services-under-affordable-care-act
The deadly Colorado shooting underscores the need to better identify, diagnose and treat people with mental illness. Diane and guests will discuss the future of mental health services under the Affordable Care Act.
Guests
Dr. Steven Daviss
chairman of the psychiatry department at the University of Maryland Baltimore-Washington Medical Center.
Rachel Garfield
senior researcher and associate director of the Kaiser Family Foundation.
Pamela Hyde
administrator of the Substance Abuse and Mental Health Services Administration.
Richard Frank
professor of health economics at Harvard Medical School.
Comments
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Obamacare spends more than $1 trillion, CBO predicts it will leave 30 million Americans uninsured, falling far short of what was promised.
•Obamacare falls far short of its promise for universal coverage. Since day one, it’s been clear that Obamacare will not achieve universal coverage, and every time CBO revisits the law, the numbers show just that. In March 2010, when the law passed, CBO predicted that there would be 22 million people still without insurance in 2019. In March 2012, the estimate increased to 27 million in 2022. Now, the number has once again increased—to 30 million. So Obamacare leaves just as many people uninsured as it covers.
•Massive uncertainty underlies CBO’s estimate. According to CBO, “what states will be able to do and what they will decide to do are both highly uncertain. As a result…[the] estimates reflect an assessment of the probabilities of different outcomes…in the middle of the distribution of possible outcomes.” As CBO points out, states’ decisions to expand or not expand Medicaid hinge on a number of factors, including their budget outlooks. States that decide to expand would face “a large extra cost.”
The simple solution is universal healthcare. There are two essentials to getting the economy moving again.
1) Total Debt forgiveness
2) Universal Healthcare
Otherwise there is nothing to discuss and we will continue sinking into the morass.
If your going to use the Colorado shooting as an example for the need of increased psychological monitoring of the populous, shouldn't we wait, and apparently it is a long wait to find out the level of incompetence associated with treatment of James Holmes.
"University of Colorado, Denver psychiatrist Lynne Fenton was reprimanded by Colorado's board of medical examiners in February 2005 for improperly prescribing drugs to herself, an employee, and her own husband, ABC's affiliate in Denver reported Saturday"
"Those drugs included the painkiller Vicodin and the anti-anxiety drug Xanax".
Read more: http://www.businessinsider.com/james-holmes-psychiatrist-reprimand-2012-...
"total debt forgiveness" who pays for that?
The Affordable Care Act was recently re-scored by CBO after the mandate ruling. The result was that it STILL SAVES TAX DOLLARS although at a lesser rate than the earlier scoring..........because the potential requirement for states to take on uninsured in Medicaid can be REJECTED BY REPUBLICAN GOVERNORS....not because the program costs more or raises new taxes.
As with all other health issues, early detection of mental health and behavioral problems is necessary. Unfortunately, parents and other relatives historically have delayed reporting issues. Mental problems have been handled all too often with superstition, ignorance, and fear. No legislation can force reporting of such problems.....it requires a societal acknowlegement and action.
Many veterans deal with prolonged mental health issues. Would the panel please discuss how the ACA could benefit this segment of the population?
LibVet wrote: "The result was that it STILL SAVES TAX DOLLARS"
You can't say it "saves tax dollars" when people will be in reality paying higher taxes to pay for it. The mandate is a tax, these mostly young people were paying nothing before, there are many working people who's spouse covered them with health care but now their employers will be forced to pay into the system . There are also other new taxes that are coming on line. The tax payer paid subsidy is well over 100 billion a year. This is what is so laughable about the people who say this monstrosity does anything to curb costs or save money. The only thing the "affordable care act" does is make the existing system bigger, less efficient and more expensive. Sorry there is no pot of gold at the end of this socialist rainbow.
"The Congressional Budget Office (CBO) has estimated that this new premium assistance program will cost $113 billion annually by 2019, with premium assistance going to an additional 19 million Americans (the Medicaid expansion will add 16 million new people to the program at a cost of $97 billion in 2017)"
Obamacare law contains 20 new or higher taxes on American families and small businesses
Read more: http://atr.org/full-list-obamacare-tax-hikes-listed-a7010#ixzz22CnEwOsQ
http://www.obamacarewatch.org/primer/exchanges-and-premium-subsidies
Former CBO Director Doug Holtz-Eakin has estimated that employers will have strong incentives to move as many as 35 million workers who will be eligible for premium assistance out of employer plans and into subsidized coverage provided through the exchanges because both the employers and the workers will be better off if they are able to access the large new federal subsidies available to exchange enrollees. Holtz-Eakin estimates that adding this many additional subsidized workers in the exchanges would add about $1 trillion over the next ten years to the cost projections provided by CBO
The new premium assistance program penalizes married couples. For instance, if two people each earn $30,000 annually, on their own, they would be judged to have incomes at about 300 percent of the FPL. But if that couple were to marry, their combined income would total $60,000, or about 500 percent of the FPL for a household with two people.
Work Incentives
The new premium assistance program provides powerful disincentives to work by imposing high implicit marginal tax rates on additional earned income. This occurs because large amounts of federal premium assistance is withdrawn at various points on the income scale. For example, a family of four earning just below $88,000, or 400 percent of the poverty level, will receive about $5,000 in annual subsidies to purchase insurance in 2016. Once that threshold is crossed, the subsidy immediately drops to zero. So for a family of four in that income range, a raise in wages would actually result in a significant reduction in take-home pay. The same disincentive applies at other points in the income scale, as premium assistance drops abruptly with small amounts of additional earned income. In fact, combined with explicit federal taxes (income and payroll taxes), the implicit tax associated with the withdrawal of premium assistance can push the effective marginal tax rates on earned income for many low and middle income households to well above 60 percent.
..
I would like to propose a form of protest for those that are still against the new insurance law: drop your insurance. If it is so bad that people be required to have it, do away with yours. That'll show E'm!
I got a better idea, throw Obama out of office and repeal Obamacare.
Why have you narrowed your mental illness discussion this morning to the "affordable" healthcare act; does this help you avoid mentioning Rep. Jackson's mental problems as a rich citizen.
My heart started weeping when hearing this topic. I've been battling depression most of my life. Even as I take my Cymbalta, I'm depressed. At nearly $200 per month and no insurance, the cost of the medication presses against my depression. I have no homicidal thoughts, I handle my suicidal thoughts--they are not prominent. I am grateful that this topic is being exposed. Thank you.
My son, who is an autistic high school student, has been a continuous victim of bullying. In the process of sorting out the most recent incident the administration was very quick to suggest that my son should be suspended or even be moved out of his base school. Once it was discovered that he was not the perpetrator but the victim, no one in the administration came back to apologize for their rush to judgement. Had it not been for his teachers, who knew him and believed in him, we could have had a very different outcome. I heard your guests say twice, that people with mental illness are more often victims than perpetrators. Why aren't the professionals more aware and more understanding of this?
I was diagnosed with schizophrenia (later revised to schizoaffective disorder) in 1974. At the time I was married to an army officer and recieved care at Walter Reed. Subsequently I worked as a manager and executive in the financial industry, including a Fortune 50 company. I had excellent health care coverage during my 30 year career. Throughout those years my condition improved. I have not required medication for more than 25 years (except for a brief period of depression following family members' deaths).
Now in my 60s and retired, I am increasingly concerned about the availability of Medicare supplemental converage at a reasonable cost. (I have been denied life insurance because of my early mental health diagnosis.)
Will you please ask your guests to address two questions:
1. What is the incidence of substantial improvement in mental health conditions?
2. Do insurance companies ever modify their statistical models to aqccommodate people whose profiles are silimar to mine?
I am grateful to you, Diane, for addressing this important topic.
Sincerely,
Theresa H. Fulton
(Please withhold my name as I don't feel confident that the stigma of mental illness has deminised sufficiently for me to reveal my condition to all of your listeners.)
My heart started weeping when hearing this topic. I've been battling depression most of my life. Even as I take my Cymbalta, I'm depressed. At nearly $200 per month and no insurance, the cost of the medication presses against my depression. I have no homicidal thoughts, I handle my suicidal thoughts--they are not prominent. I am grateful that this topic is being exposed. Thank you.
Like Richard said, there does seem to be a trend of over diagnosis, the recent invention of restless leg syndrome or , as some say, female sexual dysfunction, reveals the current trend by pharmaceutical companies to seek to shove pills down the throats of healthy people. Clinical Depression has been shown to be treated more effectively by exercise than by anti-depressants.
OK People with mental disorders are more likely to be victims than perpatrators. But are they more likely to be perpatrators than someone
without a mental disorder?
I think I heard Diane say in her intro that mental illness is a leading cause of infidelity in the US and Canada. Did I hear that correctly? If so, can anyone direct me to the source of that statistic?
Thanks,
Gary
The UMC has elected to stop disability payments to pastors after two years of eligibility; all other disabilities remain unaffected. This is apply due to the financial liability of continued coverage of those of us currently being covered.
We need your voice, Diane, to bring this act to light. I can put you in touch with those who are more educated on this issue.
Sincerely,
Rev. Michael W. McKinney Sr.
bipolarpastor@yahoo.com
http://hidingbehindthepulpit.blogspot.com
Dear Diane:
I will rewrite my submission and perhaps send it snail mail. The state of affairs regarding Mental Illness in this country is SO BAD, yet thousands of professionals in the field earn handsome salaries while the patients wallow in a system that offers them tokenism. You heard your guests talk about all these new paradigms, screening procedures, integrated treatment protocols for people with mental illness and substance abuse, mental illness and physical illness, community treatment teams, peer counselors, yada yada. Thanks for listening. I realized today that the depth of my anger at the system for taking my daughter from me nine years ago can't be cooled by anything but speaking out wherever I can. One question I have is where the 1 in 3 and 1 in 5 numbers came from. NAMI(the organization that says it is the Nation's Voice on Mental Illness) used to estimate than 1 in 4 Americans will have a diagnosable mental illness at some time in their lives. I work with NAMI for many years, several in leadership roles. I now view the organization with much skepticism.
Dr., you mentioned comorbidities associated with migraine include stroke and brain lesions. Kindly advise what sort of follow-up is advised for migraine sufferers who have had strokes.