Our Health Policy Matters

It has been a busy health policy year.  Here are my choices for the top health policy stories.  They all may not have made big headlines, but all will reverberate for some time.  The Slowing of Healthcare Inflation This was on my watch list coming into this year , and I’ll lead with it today because it was the best health policy news of the year.  When healthcare inflation came in low this year, it did all sorts of good things.  It helped balance state budgets, extended the life of the Medicare Trust Fund, and dropped the price tag of the Affordable Care Act.  Inflation is supposed to jump up this year as millions more become insured, but we can at least hope that a more modest trendline continues. Mental Health Parity And for some more good news… It took five years and incessant lobbying from heroes like Patrick Kennedy, but the final rule implementing the Mental Health Parity Act of 2008 was finally released this year , coinciding roug...

It has been a busy health policy year.  Here are my choices for the top health policy stories.  They all may not have made big headlines, but all will reverberate for some time.  The Slowing of Healthcare Inflation This was on my watch list coming into this year , and I’ll lead with it today because it was the best health policy news of the year.  When healthcare inflation came in low this year, it did all sorts of good things.  It helped balance state budgets, extended the life of the Medicare Trust Fund, and dropped the price tag of the Affordable Care Act.  Inflation is supposed to jump up this year as millions more become insured, but we can at least hope that a more modest trendline continues. Mental Health Parity And for some more good news… It took five years and incessant lobbying from heroes like Patrick Kennedy, but the final rule implementing the Mental Health Parity Act of 2008 was finally released this year , coinciding roug...

As Congress lurches today toward what at best will be another short-term “solution” to the debt ceiling and government shutdown debacle, there is a reason to believe that it will never effectively tackle entitlements.  What we need and what we want are two different things.  And this inept Congress – which in the eleventh hour of its most recent manufactured crisis is still posturing over Obamacare – has no idea how to balance the two.  Source: US House Website We need our entitlements – that’s why they exist.  But we also don’t want to pay for them. Take the Affordable Care Act – in the crosshairs of so many politicians – as an example.  Next to no one wants it all repealed.  Coverage for pre-existing conditions, a guarantee that insurance won’t be cancelled even after an illness hits, and tax credits to lower the cost of health insurance are all needed and immensely popular. But these things cost money.  When Congress passed the ...

As Congress lurches today toward what at best will be another short-term “solution” to the debt ceiling and government shutdown debacle, there is a reason to believe that it will never effectively tackle entitlements.  What we need and what we want are two different things.  And this inept Congress – which in the eleventh hour of its most recent manufactured crisis is still posturing over Obamacare – has no idea how to balance the two.  Source: US House Website We need our entitlements – that’s why they exist.  But we also don’t want to pay for them. Take the Affordable Care Act – in the crosshairs of so many politicians – as an example.  Next to no one wants it all repealed.  Coverage for pre-existing conditions, a guarantee that insurance won’t be cancelled even after an illness hits, and tax credits to lower the cost of health insurance are all needed and immensely popular. But these things cost money.  When Congress passed the ...

In 2009, there were 36,891 suicides in the United States, according to the CDC .  This translates to a rate of 11.9 for every 100,000 people. And rates among certain groups were even higher.  For example, the suicide rate among veterans, according to the Veterans Administration, was three times higher – or 35.9 per 100,000 veterans. Suicide is a problem that ought to command our attention. And it does.  For many years we have used suicide data as surrogates for documenting the consequences of serious mental illness.  We all know that the “danger to self” standard we use for determining when people with mental illness qualify for emergency care is, in effect, a “suicide may be imminent” standard. As a result, for many years community mental health organizations have also been asked to track suicides as a measure of the effectiveness of their programming.  But there are reasons why focusing on suicide rates too closely leads to inadequa...

In 2009, there were 36,891 suicides in the United States, according to the CDC .  This translates to a rate of 11.9 for every 100,000 people. And rates among certain groups were even higher.  For example, the suicide rate among veterans, according to the Veterans Administration, was three times higher – or 35.9 per 100,000 veterans. Suicide is a problem that ought to command our attention. And it does.  For many years we have used suicide data as surrogates for documenting the consequences of serious mental illness.  We all know that the “danger to self” standard we use for determining when people with mental illness qualify for emergency care is, in effect, a “suicide may be imminent” standard. As a result, for many years community mental health organizations have also been asked to track suicides as a measure of the effectiveness of their programming.  But there are reasons why focusing on suicide rates too closely leads to inadequa...

Fifty-four percent of Iraq and Afghanistan war veterans who have sought treatment in the VA system since 2001 have been treated for mental disorders. This is the second most-frequent diagnosis among these veterans.  It is an indicator of the profound effect recent war service is having on the mental health and well-being of our veterans. The data come from a March, 2013, report entitled Analysis of VA Healthcare Utilization Among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) Veterans .   Here are some numbers that reflect how extensive the use of VA services has been during the last decade. As of the end of 2012, 2.5 million troops had served since the beginning of the Iraq and Afghanistan wars.  Just over 1.6 million had become eligible for VA healthcare.  Of that group, almost 900,000 had used VA healthcare services by the end of 2012. These 900,000 veterans most often sought treatment in VA cen...

Fifty-four percent of Iraq and Afghanistan war veterans who have sought treatment in the VA system since 2001 have been treated for mental disorders. This is the second most-frequent diagnosis among these veterans.  It is an indicator of the profound effect recent war service is having on the mental health and well-being of our veterans. The data come from a March, 2013, report entitled Analysis of VA Healthcare Utilization Among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) Veterans .   Here are some numbers that reflect how extensive the use of VA services has been during the last decade. As of the end of 2012, 2.5 million troops had served since the beginning of the Iraq and Afghanistan wars.  Just over 1.6 million had become eligible for VA healthcare.  Of that group, almost 900,000 had used VA healthcare services by the end of 2012. These 900,000 veterans most often sought treatment in VA cen...

Former U.S. Congressman Patrick Kennedy was in South Florida last week pushing the radical idea that all people, including those with mental illness, are created equal. What makes this idea radical in 2012 is that we continue to discriminate against the 6% of Americans who have serious mental illnesses.  Patrick Kennedy understands this, and is devoting his life after Congress to fighting on their behalf. It is a fight that affects him personally, as it does the one-fifth of all children and the one-fourth of all adults with a diagnosable mental illness each year. Discrimination against people with mental illness takes on many forms – arrests for loitering, incarceration instead of treatment, and perhaps most commonly in the unequal coverage by insurers for mental health conditions. This last form of discrimination was supposed to have ended with the passage of the Mental Health Parity and Addiction Equity Act of 2008.  But the federal “rule” implementing t...

Former U.S. Congressman Patrick Kennedy was in South Florida last week pushing the radical idea that all people, including those with mental illness, are created equal. What makes this idea radical in 2012 is that we continue to discriminate against the 6% of Americans who have serious mental illnesses.  Patrick Kennedy understands this, and is devoting his life after Congress to fighting on their behalf. It is a fight that affects him personally, as it does the one-fifth of all children and the one-fourth of all adults with a diagnosable mental illness each year. Discrimination against people with mental illness takes on many forms – arrests for loitering, incarceration instead of treatment, and perhaps most commonly in the unequal coverage by insurers for mental health conditions. This last form of discrimination was supposed to have ended with the passage of the Mental Health Parity and Addiction Equity Act of 2008.  But the federal “rule” implementing t...

“In 2011, mental disorders accounted for more hospitalizations of U.S. service members than any other diagnostic category.” – Armed Forces Health Surveillance Center Medical Surveillance Monthly Report, June 2012 Recently, my daughter Elizabeth told me about a friend who stopped in to see her at the mall where she works while attending college.  Like her, he’s in his early twenties.  They worked together at a toy store a few years ago, and she hadn’t seen him since then. He had enlisted in the army.  He was deployed overseas twice, and served a tour in a war zone.  He sustained a minor physical injury, now healed, while serving. She said that he seemed a little down in the dumps when she saw him.  He told her that he is having trouble with his relationships since his return, but doesn’t think there’s anything wrong with him.  He’s pretty sure he doesn’t have PTSD, and sees no reason to seek counseling or other mental health supports. Ins...

“In 2011, mental disorders accounted for more hospitalizations of U.S. service members than any other diagnostic category.” – Armed Forces Health Surveillance Center Medical Surveillance Monthly Report, June 2012 Recently, my daughter Elizabeth told me about a friend who stopped in to see her at the mall where she works while attending college.  Like her, he’s in his early twenties.  They worked together at a toy store a few years ago, and she hadn’t seen him since then. He had enlisted in the army.  He was deployed overseas twice, and served a tour in a war zone.  He sustained a minor physical injury, now healed, while serving. She said that he seemed a little down in the dumps when she saw him.  He told her that he is having trouble with his relationships since his return, but doesn’t think there’s anything wrong with him.  He’s pretty sure he doesn’t have PTSD, and sees no reason to seek counseling or other mental health supports. Ins...