Are our healthcare facilities inadequate?

It is often discussed how insurance providers make money but do not provide adequate coverage for medical bills and still find loopholes to charge extra fees and deny covering certain treatments or procedures.

Healthcare costs have gone over the head throughout the globe and when insurance does not cover them, it becomes a huge burden on the backs of people who are already suffering from some health issue or the other.

However, an important conversation that is missing from the healthcare scene altogether­- perhaps, deliberately eliminated due to a capitalist society’s needs for reducing expenses for maximized profits- is the impact of mental health in a person’s overall well-being. Apart from the taboos associated, health insurance plans do not offer any coverage whatsoever to issues associated with mental health.

Health insurance policies in the US aren’t any different than health insurance policies in India when it comes to providing healthcare that truly aims at providing coverage for the all-round well-being of the policyholders.

Mental health IS health

The brain is an organ like any other. If any organ is not working well, we understand that it needs attention and rest.

Such a simple understanding is lacking from minds when it comes to issues of mental health, which, more often than not, are centered in the brain.

Issues like ADHD, Anxiety, Alzheimer’s, Autism, Bipolar, Depression, OCD, PTSD, and Schizophrenia are more common than one would like to admit. Clearly, a part of the reason is the lack of conversation around them.

Why we need better coverage for Mental Health Ailments

Insurance cover for mental health ailments is only the first step towards improving the over-all scene of steadily-worsening mental health.

Some ways in which it will help are:

  1. Greater accessibility

Due to the high costs of medical aid for mental health-care patients are reluctant to seek assistance.

Insurance lacks coverage for mental health ailments, which is why patients have lower or no access to medical help and have to turn to charlatans, or even live through the perpetual discomfort until it takes their life.

If insurance providers gave a better cover to mental health ailments, rather than the insubstantial false-front, it would encourage ailing people to seek medical help sooner.

  1. Improvement of mental health services

As the number of patients reaching out to doctors will increase, it is only a matter of time until research funding will go up too.

With better research and more scholarships, the quality of medical assistance for mental ailments will improve substantially, and so will the quality of life.

  1. Social acceptance and de-stigmatization

Across the world, in Western and Eastern societies, a stigma pervades the space of mental health.

When it is difficult to have a conversation about mental health, seeking medical assistance becomes so much more difficult.

With the acceptance of mental health in legislation and improvement in healthcare and services, it will become much easier to talk about mental health; society, as a whole, will benefit from this substantially.

Where are the authorities?

Mental Health is internationally recognized as a non-negotiable part of a person’s health.

However, it is surprising to see how this knowledge seems to have been completely missed by health insurance providers across the world.

The importance and place of mental health in areas of personal finance and the impact it has on the GDPs of nations across the world as well as on global economy has not been satisfactorily discussed.

WHO recognizes mental health as the key to achieving ‘Global Goals’ while blatant neglect makes it a hurdle in achieving these goals. UN also includes Mental Health in its Sustainable Development Goals.

Despite laws being enacted in countries across the world, insurers still offer cover for physical health with only a marginal portion for mental health.

Legislations and their inefficacy

The US has enacted laws like the Mental Health Parity Act (MHPA) (1996), the Mental Health Parity and Addiction Equity Act (MHPAEA) (2010), and the Affordable Care Act (2010). Not only do insurance providers continue to provide insufficient cover for mental health or charge extensively for it, they even charge higher co-pays and deductibles while imposing caps on the number of hospital visits allowed under the policies for mental health patients.

China, in a historical move, initiated its first mental health law amidst the shocking revelation of a negligible number of mental health facilities throughout the country, and recurring news of human rights violation in the aforesaid health facilities. On May 1st, 2013, the first mental health law of China came into effect.

The law has principles attempting to integrate prevention, treatment, and rehabilitation of mental health and has a comprehensive management mechanism.

The lack of baseline research in China prevents the proper implementation the law, but it is sufficiently clear that there are many loopholes, ranging from the lack of patient’s rights, to unclear guidelines on how the law attempts to improve mental health. Also, dealing with the societal pressure due to the stigma associated with these issues was not made any easier by the introduction of this law.

World Psychiatry brings attention to the fact that in Latin America, mental health issues, accompanied by plaguing poverty, make life very difficult.

The Declaration of Caracas was crafted as a result of enormous pressure from international organizations and revealed the following about Latin American countries:

  • only 64.5% have specific mental health policies,
  • only 80.6% have plans and mental health programs,
  • only 67.9% have specific legislation around mental health,
  • and only 87.1% have disability benefits for psychiatric patients.

But, there is lack of documentation of whether these measures merely exist on paper or if they are being effectively implemented and utilized.

In Singapore, Medisave, which is Singaporean’s national medical savings account, now offers coverage for mental health treatments due to an increased awareness. But, there is a clear lack of laws and even Medisave cover is capped at a limit.

Health insurance in India is anyway not accurate, as only 17% of the population is covered according to an IRDA estimate from 2014. However, the government had enacted the Mental Healthcare Act in April 2017 which is expected to come into effect by July 2018.

These are countries which are growing exponentially, but the lack of legislation and proper implementation of any laws they might have, is slowing them down- economies and societies alike.

While some countries decree equal cover for mental and physical health, there are many more which completely exclude mental health from the agenda.

Start a conversation

In a profit-driven society, change is possible only when the people demand for it by dismissing what is inadequate.

Asking insurers to cover mental health under health insurance plans will serve as the first step to this change.

A Google search for ‘Mental Health Insurance’ will give you no genuine results at all.

This goes on to show that despite glittering recognitions, raving discussion, and blazon laws, we are nowhere near to bringing about a change that is tangible enough to affect the lives of people.

For this, it is crucial to have conversations about mental health. They may seem difficult at first, but that is only because of lack of understanding and the fear of being judged.

Starting the dialogue is necessary to improve the overall healthcare situation in societies across the world.

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