As we all know the new draft of the Republican Health Care Bill has been released from the secret rooms of congress. There are, of course, many troubling issues with this current draft. I need to focus on only one, however, for me to dismiss the whole thing as insufficient and unpassable.
The current draft of this bill provides for states to choose whether or not they want to cover behavioral health and/or addiction with allotted insurance funding. I have called my legislators to inquire about the logic behind this, but have received no answer. My first and perhaps most shallow concern with this has to do with practicality – cost vs. benefit. If a state chooses not to cover needed mental health and addiction services, do the costs for caring for this population go away, or merely shift? I know that if mental health and addiction coverage are not provided in the state of Tennessee, or any state, the American Health Care Act is going to be more costly to everyone than we can even imagine.
The most obvious outcomes of waiving these kinds of coverage would likely include increased rates of suicide, increased drug abuse (opioid crisis), increased crime and incarcerations. Additionally, and ironically, a lack of coverage for some of our most vulnerable populations will increase our health care costs as these folks will have nowhere else to turn for help but the local emergency room. Hospitals cannot afford to take this kind of hit and will need to pass the costs off to other patients. These costs could be so burdensome to some of Tennessee’s more rural medical centers that they may eventually face closure. I recognize this sounds like a bit of a slippery-slope argument here, but I truly believe that if this treatment coverage is denied to those who need it—everyone will be affected, and many WILL BE HURT.
My other concern with this optionality is the messaging. What does this kind of stance say about people who struggle with these concerns? Very often people whose lives are hindered by addiction and/or mental health don’t seek treatment because of stigma, because many in society, including undereducated lawmakers, still attempt to see these things as choices. As someone who struggles, at times, with anxiety I know it’s not a choice. As someone who has loved ones who suffer with depression, I can tell you that they don’t wake up one day and say to themselves, “I hope today I can feel hopeless. I wish that today I could curl up into a ball and avoid living”. As such, I am very concerned with how this portion of the bill serves to further separate and stigmatize this population.
Depression and addiction are very often the treatable result of adverse early childhood experiences (tons of replicated research available on this topic if you care to look). And, of course, I am concerned with this idea of choosing in general. I believe that there is not a single life that should be on the “optional” block, not one single life that is worth losing due to lack of health coverage. Not if it’s my child, my father, my sister, my friend, my neighbor, or even some stranger on the other side of Tennessee whom I may never meet. Please, please, keep fighting. Call and tell your senators to go back to their drafting room, and maybe do a little more thinking this time. We need a plan that is cost effective and humane to all citizens (as Trump promised on the campaign trail), not just the wealthy, the young, and the well.