Question:
- Hide quoted text — Show quoted text – (Chiquitita) writes: But this isn’t listed in the guidelines of payment for outpatient psychotherapy and therefore doesn’t get paid. Great, isn’t it? the reason insurance doesn’t pay for therapy for "mental" illnesses is that they don’t have to because the majority of people don’t care if people like me have to go into bankruptcy because of hospital and therapy bills. but tell the world that the insurance companies are no longer going to treat cancer or allow catastrophic coverage for cancer patients and the outcry would overwhelm the politicians from the president down to the dog-catcher. the president has mentioned parity in insurance coverage which would require insurance companies to cover mental illness in the same way they do physical illness. how many of you are willing to write lots of letters and make lots of phone calls in support of this idea? I’ll get off my soap-box now. thanks for listening.
Spoilered because I’m ranting…. bitch moan bitch moan bitch moan bitch moan bitch and one last moan…. wanting and getting are two different things… I’ve gotten no few things from the ’system’ that I didn’t want and I’d like to warn people that what they want requires a lot more care than the system is commonly able to muster. I apologize to people in advance, this is a very hot button for me and I really wish that there had been a correct diagnosis and treatment given me in 1976 when I was hospitalized for months. Or that there was someone that gave a damn when I went for help starting two years before the collapse that took a year of revolving door hospitalizations to regain control of some semblance of the ability for self-care. As I understand it, insurance started as a way to keep more people at work in the factories. It was created strictly to be a quick fix and just enough for people to feel they dropped the dime in the begger’s cup. (much cynical irony) Reality bites and takes a big chunk out of anyone that isn’t big, mean and very much a perp. You have my sympathy… I went through a bankruptcy and no end of rough times because I couldn’t get myself together enough to ask for the help that was available. (IE. I spent months living in a car that I probably shouldn’t have been driving because I was too dissociative to stay focused on what I was doing.) I’d like to have insurance companies cover mental illness in the same way they do physical illness. Not that either has done me much good. (Pre-existing conditions are usually not covered for the first year when they aren’t too expensive, but things like hemo-dialisis for kidney patients or equally expensive long term support treatments never have been covered when you change providers.) Treatment for DDs or PTSD is a long-term process. It usually is five to ten years. But they have a startlingly high ‘cure’ rate. Much better than the chemical or structural disorders. The average bill is something over fifty thousand dollars just in therapy costs… Plus ten thousand for each week of in-patient hospital care. (In-patient care is strictly custodial care, therapy in a hospital situation is much less likely to have the trust and impact that a long term therapy relationship can.) My point is; It would be great to have the coverage, but who is willing to pay the bill and would you trust them to have your care as the most important thing on their mind? I’ve had a HMO try to manage my psyc care and I feel they were criminally negligent in developing a proper diagnosis, worse at providing anything more than someone to sit the suicide watch and very quick to use drugs as the best method of quieting a squeaky wheel. Psyc care is still very much an art and not a science. The understanding of psycoactive drugs is still in it’s infancy. The side effects of the drugs currently in use are only acceptable because the condition they treat is just barely worse than the ‘cure’. It would be neat if we could vote ourselves the availablity of the existing treatment, better if we could produce some greater consistancy in the availability and quality of treatment and best if we could simple prevent the need for such treatment by doing away with the abuse that created the need in the first place. <snort <huff <huff <heavy sigh I lost my kids, my home and my dignity to the system when I’d trusted it to provide for me in return for thousands paid into Social Security, HMO’s and taxes. Unless you are very nearly able to do for yourself, the system won’t do for you. Fifteen years of stuffing my own problems to take care of others and the return was just enough to prevent me from dying from starvation as I nearly froze to death sleeping in a car. It was a year and a half effort to recover enough that I could stay connected with what was happening instead of letting the protector alter run the show and dissociating from the horror of my exist. <huff I’m probably the bottom edge of the DID community because of my lack of ability to cope, but I supposedly had some of the very best care available as part of the HMO and it didn’t do diddly when the crisis came. There isn’t a quick fix for the system. I’ve written letters until my fingers have cramped from the typing, but until the diagnosis of Disociative Disorders and the whole field of Trauma related treatment has stabilized, I feel it’s much more important to work to inform and train professionals so that they have a chance to make the mental health coverage meaningful. I’m willing to write letters and make phone-calls, but there is precious little available from the system and a lot of rude noises trying to get even the minimum they’ve already promised to provide from them. (So speaks a medicare patient that has to keep begging for even the money to talk with the LCSW that has been managing their therapy.) Heaven forbid that I might need to see a doctor for a medical problem… The last time I went to the county hospital, I was told that I had the flu, three days later I was back with a fever of 104 because the strep throat had started to become necrotic. For the want of 15$ worth of antibiotics, I needed to be hospitalized and have surgery to repair the damage. I don’t trust the system to cope with what is being asked of it to start with. Unless there is some magic ability to stretch the tax dollars or some wonder change in the way of things, I don’t see how the system will manage to do more than make things worse for more people. Ignore me, I’m ranting on a soap-box because I’m tired of trying to fight the system. I’ve managed to get one overworked and underpaid doctor in trouble at the hospital… so now there is one less doctor to treat the people that show up at the only hospital for forty miles that will treat medicare patients. Not to belittle the desire for treatment at reduced prices, but is there really a willingness in people to give a fig? I do, but I sure haven’t seen many others. Robin ranting about feeling helpless and hopeless trying to deal with the system. (.
Response:
We heard the latest "reasoning" yesterday and wonder what else they will pull out of their hat… They used to say: The client is too sane and doesn’t need therapy any longer. The client is too severely damaged and therapy won’t help. The therapist isn’t analytically trained, and thus can’t handle transference issues. (You are only allowed to love analytical Freudian therapists.) And now they say: OK, high frequent longterm outpatient therapy is the method of choice to treat dissociative disorders. Point. There may be positive results. Point. But this isn’t listed in the guidelines of payment for outpatient psychotherapy and therefore doesn’t get paid. Great, isn’t it? Chiquitita — Some things are melting now what’s it gonna take till my baby’s all right? — For more information about this service, send e-mail to:
Response:
I hear ya on this. Also, they neglect to say that pharmacology is efffective only as an adjuunct to psychotherapy, not as a cure. Cyn P.S. of course if all comes down to money. So I guess my next study will be a cost-benefit about long term outpatient therapy costs versus frequent short-term inhospitalizations over the course of time it takes to "cure" a patient. – Hide quoted text — Show quoted text – We heard the latest "reasoning" yesterday and wonder what else they will pull out of their hat… They used to say: The client is too sane and doesn’t need therapy any longer. The client is too severely damaged and therapy won’t help. The therapist isn’t analytically trained, and thus can’t handle transference issues. (You are only allowed to love analytical Freudian therapists.) And now they say: OK, high frequent longterm outpatient therapy is the method of choice to treat dissociative disorders. Point. There may be positive results. Point. But this isn’t listed in the guidelines of payment for outpatient psychotherapy and therefore doesn’t get paid. Great, isn’t it? Chiquitita — Some things are melting now what’s it gonna take till my baby’s all right? — For more information about this service, send e-mail to:
Response:
I believe that the parity bill or a compramise has been passed by both houses and signed into law. It basically says that Insurance companies dont have to cover mental illness but if they do they have to cover it on the same level as physical illness, however the kicker is that they can charge higher co-payments. If they offer mental health coverage they cannot pick an arbitrary number of visits and that’s it, they have to pay for what a patient needs ( I dont know who decides that though). Not what we wanted but a step in the right direction unless ins people stop covering mental health all together. I may be wrong on this but I think it’s a done deal. ACESTAR
Response:
(Chiquitita) writes: But this isn’t listed in the guidelines of payment for outpatient psychotherapy and therefore doesn’t get paid. Great, isn’t it?
the reason insurance doesn’t pay for therapy for "mental" illnesses is that they don’t have to because the majority of people don’t care if people like me have to go into bankruptcy because of hospital and therapy bills. but tell the world that the insurance companies are no longer going to treat cancer or allow catastrophic coverage for cancer patients and the outcry would overwhelm the politicians from the president down to the dog-catcher. the president has mentioned parity in insurance coverage which would require insurance companies to cover mental illness in the same way they do physical illness. how many of you are willing to write lots of letters and make lots of phone calls in support of this idea? I’ll get off my soap-box now. thanks for listening.
Response:
ROBIN RANT ON! RANT ON! RIGHT ON! WHAT YOU SAID! ACESTAR
Response:
the reason insurance doesn’t pay for therapy for "mental" illnesses is that they don’t have to because the majority of people don’t care if people like me have to go into bankruptcy because of hospital and therapy
Nah, you’re missing the most important thing: profit. They have no interest in getting you or anyone else better, and they don’t HAVE to. Plus, the managed care companies can’t deal with DID, as they can’t just prescribe meds or authorize 6 visits to `clear it up.’ the president has mentioned parity in insurance coverage which would require insurance companies to cover mental illness in the same way they
I was under the impression that this was passed, in terms of maximum benefits for physical and mental. http://www.netaxs.com/~jeffv http://www.netaxs.com/~nukefish lefty guitar info, musical humor song parodies, as heard on Stern show
Response:
I believe that the parity bill or a compramise has been passed by both houses and signed into law. It basically says that Insurance companies dont have to cover mental illness but if they do they have to cover it on the same level as physical illness, however the kicker is that they can charge higher co-payments. If they offer mental health coverage they cannot pick an arbitrary number of visits and that’s it, they have to pay for what a patient needs ( I dont know who decides that though). Not what we wanted but a step in the right direction unless ins people stop covering mental health all together. I may be wrong on this but I think it’s a done deal. ACESTAR
I don’t have the exact details, but my understanding was that the bill that was passed was *much* watered down from the proposal and that the only parity that was actually achieved was that the insurance company has to offer the same lifetime (and yearly dollar?) limits to both medical and mental health benefits, if they offer mental health benefits at all. they don’t have to cover mental health. they can charge different copays. they can limit the conditions for which they provide coverage. they can limit the providers they will cover. they can still make their arbitrary decisions regarding what is "medically necessary" and then change their minds on a retrospective review, even after they okay a treatment. they can’t withdraw your coverage if you change or lose your job. they can, however, charge you four times what your employer was paying and change your benefits to the same sh*t plan they offer all the other independent suckers. this is a step in the right direction? it’s more like leaning forward a little bit. thanks to our republican legislature…. what? *me* bitter? astri #AKA pink bunnies# `o’_* |/(((( |/ All conditions are temporary — For more information about this service, send e-mail to:
Response:
I may be wrong on this but I think it’s a done deal. ACESTAR
i haven’t seen any sign of any changes such as you describe yet, and our open season( i’m a federal worker) is now. so far, still pay medical, don’t pay psychiatric. but i hope things get better soon.
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