By
Steven Ronik
July 12, 2009
For individuals with mental illness or addiction,
lack of insurance coverage that provides access
to a comprehensive array of physical and behavioral
health services greatly impacts their overall
health and well-being. Reforming health care
is necessary to protect individuals and families.
I
am issuing an urgent plea for Congress to continue
its national health care reform efforts to address
concerns over unmet needs for services and the
rising number of uninsured. I am calling for
health reform to include mental health and addiction
services in all components of health care reform
to address the health care needs of individuals
with mental health and substance abuse problems.
Health
care reform is about the almost 50 million Americans
in Florida and nationwide living without coverage,
and those people who have health insurance but
can no longer afford rising out-of-pocket costs.
Health
care premiums have been rising six times faster
than wages since 2000. Also, more people are
losing their health insurance along with their
jobs.
Mental
illness drains our economy of more than $80
billion every year. Alcohol and drug abuse contributes
to the death of more than 100,000 Americans
and costs upward of half a trillion dollars
a year.
A
quarter of all Social Security disability payments
are for individuals with mental illness.
The
goal of health care reform should be to provide
quality, affordable health insurance for all
Americans. Quality health care means coverage
must include mental health and substance abuse
disorders in all parts of health care reform.
Quality
health care should focus on prevention, early
intervention and treatment and management of
chronic health care conditions.
People
with serious mental illnesses like schizophrenia
and bipolar disorder die an average of 25 years
sooner than other Americans, according to a
2006 study conducted by the National Association
of State Mental Health Program Directors. Three
out of every five people with serious mental
illnesses die from preventable, co-occurring
chronic diseases.
The
situation in South Florida is even more complex.
While we remain 48th of 50 states in per capita
mental health spending, South Florida has struggled
with the implementation of Medicaid reform.
Medicaid reform, which is essentially a synonym
for Medicaid managed care (and not real reform
at all), has turned over the care management
of those insured with Medicaid with mental illnesses
to largely for-profit HMOs.
Medicaid
reform has not only been a colossal failure
on a service level, while most of the Medicaid
physicians have dropped out of the plans, and
outcomes have not improved, but the financial
motivation to implement Medicaid reform (which
was to save money) has not occurred. Medicaid
expenditures have remained about the same, but
the money has been dramatically reduced to health
care providers.
It
is time for sweeping national health care reform.
It is time for us to come to grips with whether
health are in America is a right or a privilege.
The rest of the industrialized world views health
care as a fundamental right.
We
need to take an honest look at whether for-profit
health care is in the nation's best interest.
American capitalism and an entrepreneurial spirit
help define and invigorate America, but a for-profit
incentive for health care may just be fundamentally
wrong and has led to some perverse incentives.
When withholding health care increases, an insurance
company's or for-profit health care provider's
stock price — something has clearly gone
amiss.
The
time for real change is now. Together we can
do it. Our nation deserves it.
Dr.
Steven Ronik is chief executive officer, Henderson
Mental Health Center, Fort Lauderdale.
Copyright
© 2009, South Florida Sun-Sentinel
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