Physician Patient

Archive for March, 2019

Conundrum: Regulating the fox in the hen house of mental health parity

Sunday, March 17th, 2019

As  emphasized in the March 17 Star Tribune editorial, the real priority for achieving “mental health parity” should be to help “struggling families,” rather than enfranchising the [health care] industry. We have ample proof that insurance company payment criteria for mental and substance use disorders cover short-term and crisis-focused mental health conditions and disregard the value to patients and families of continuity of professional relationships, as well as allowing adequate payment for non-acute, complex, chronic, care (including children and adolescents). 

The (bipartisan) federal Paul Wellstone and Pete Dominici Mental Health Parity and Addiction Equity Act of 2008 (signed by President Bush) enfranchised insurers to decide on claims of “medical necessity.” Thus, an unintended consequence of (well intentioned) mental health parity legislation is industry justification for denial of third party payments for mental health care.

Why not encourage the patient’s insurance company to pay mental health insurance benefits directly to the enrollee (patient or family)? Then, regulators can monitor and compare real money spent on “physical” and “mental” conditions, and consumers can choose licensed “providers” who are responsive to their needs?

References:

http://www.startribune.com/help-those-with-mental-health-issues-by-passing-parity-bill/507227482/

Minnesota Legislation

https://www.globenewswire.com/news-release/2019/03/05/1748331/0/en/U-S-Federal-Court-Finds-UnitedHealthcare-Affiliate-Illegally-Denied-Mental-Health-and-Substance-Use-Coverage-in-Nationwide-Class-Action.html

Lee Beecher, MD
President, Minnesota Physician-Patient Alliance

Minnesotans Want Health Care Price Transparency

Sunday, March 10th, 2019

Reference: https://finance.yahoo.com/news/trump-administration-weighs-publicizing-secret-031600937.html

Minnesotans want to know the actual prices of their medical care and what their insurance plan will pay for it whenever feasible. And, patients and their families also want to know who among Minnesota’s practicing physicians and other professionals post their professional fees online and are available and willing to see them.

Absent knowing actual prices and the real-time availability of doctors, how can Minnesota consumers (patients and families) make intelligent choices about doctors, evaluating hospitals, and purchasing medical products (including medications)? Most third party health care insurance (private and public) pays the health care “provider” directly while leaving the consumer (patient and family) out of the money loop — until after the service is provided and the dreaded medical bill arrives.Our state and federal policymakers need to hear from you.

Minnesota politicians say they want price transparency. Contact them and tell them that only with real price transparency can we have a competitive health care marketplace which is shaped by the needs and preferences of individual consumers when selecting our health care services and third party insurance.