Beyond Blue

Beyond Blue


When the Cure Is Not Worth the Cost

posted by Beyond Blue

What do you guys think about this op-ed piece in the “New York Times” today by Maia Szalavitz? I have an opinion, but I want to hear yours first.



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malaki

posted April 11, 2007 at 7:53 pm


I have a lot of trouble with the argument being presented here. There are two distinct issues being blended in a way that does not make sense to me. First, there is the issue of what treatment options (including medications, therapies, etc) should be used (and presumably covered by insurance). Suggesting that covered treatment follow some sort of scientific evidence does make sense, as long as individual variations and exceptions are allowed for. There is some movement towards that already. There are preferred list of medications to try in order, and over certain time periods, for initial treatment of depression. These guidelines are readily available. For payers to want to see early care follow that path, or have the clinician specify reasons for exceptions, in order for coverage to be provided is not unreasonable. However, that is a totally separate issue from whether or not to provide expanded mental health coverage in general. I have never heard a good or logical argument for providing hard limits for mental health services. Whether dealing with inpatient mental health, substance abuse, outpatient therapy, or other services, there are large groups of people struggling to get coverage for needed services. Arbitrarily denying coverage makes no more sense than paying for everything. However, it certainly is less expensive for the provider. I believe we should push for mental health parity. If we also need to find ways to ensure that treatments are applied based on sound principles and research, that should be handled as a separate issue altogether. It should not be used as an excuse to continue to deny coverage for mental health issues.



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