Friday, October 24, 2008

Parity as Bogus Bail-out Bonus?

[credit: flickr user The_Leader]

Nice to see Clink sharing her AAPL learnings with us, as the forensic experts try to understand the behavior of forensic bogeymen (or the gender-neutral bogeypeople) like Freddie and Jason.   Just in time for Halloween

I was struck by the total lack of understanding by two nay-sayers in yesterday's Opinion column in the Baltimore Sun.  Richard Vatz and Jeffrey Schaler often write about the so-called "myth of mental illness", taking a page from the 1960 Szasz book of the same name.

In the newspaper article, they lambast our legislators for using "political legerdemain" to sneak the long-negotiated Mental Health Parity Bill into the $700B bank bail-out bill.  Their opinion is that the category of "mental illness" is too broad and too costly, and provides an impression that most people with a label of mental illness are actually just whiny babies who can't accept the responsibility of dealing with "problems in living", like death, rape, or loss of job/house/401k/spouse.  They write:
"• Supporters of parity celebrate the new law as signaling the end of "stigma," but they fail to consider that stigmatization is a marvelous negative reinforcer for undesired behavior, some of which is called "mental illness." 

• Substance disorders are arguably a function of behavioral choices and in no way constitute diseases to which insurance should apply. Such self-destructive behavior is best explained by mindset, personal values and how a person copes with his or her environment. Incidence varies by cultural context, and people can clearly stop or control their addictions through an exercise of free will. Not so when it comes to bodily illness; one can no more will away cancer, heart disease or diabetes than he or she can will their onset."
Lack of understanding.

They appear to also have a lack of understanding about how our health care system works for other (non-mental) illnesses.  One of the reasons they are against parity is that "there is no way to accurately confirm or disconfirm 'mental illness' ."  The same could be said for many somatic problems, such as headaches, back pain, nausea, and fatigue.  However, our health care system will pay for treatment of all these conditions, no matter how minor or subjective.  There is not a severity-based system where only physical conditions deemed worthy or severe enough get covered.  If you go to the doctor for a stubbed toe, the insurance company will pay for the visit and the Xray.  So, unless they advocate just as strongly for similar changes to the rest of health care, this argument does not hold water. 

By the way, I also did not like the fact that the Parity bill was tacked on to the Bail-out bill, but only because I think such a bill should pass on its own merits.  

And with Halloween right around the corner, what is truly frightening about their article is that one of the authors is an associate editor for the Psychology section of USA Today magazine, and is thus in an influential position to control what the nation's population of hotel customers and other readers get to read about these topics.  [Correction: I think this is USA Today Magazine, which appears to be a very different animal than the newspaper that gets placed in front of every hotel room door every morning... still...]