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HEALTH CARE - The Mental Health Gap

HEALTH CARE - The Mental Health Gap
REMINDERS:  Today's Affordable Care Act is NOT what President Obama envisioned when it was proposed.  It's what we got because of Congress.  President Obama did not like it when he signed it into law, but it was much better than having no health care reform.

Also, remember that Health Insurance Industry is NOT in business to provide health care, they ARE in business to MAKE A PROFIT, don't confuse method with what they are about.

Note there ARE health organizations that do actually provide heal care, I call them 'True HMOs":
  • They own and operate their own hospitals and clinics
  • They have their own medical labs for tests (only farm out what is too expensive, no added cost)
  • The doctors are employees, therefore are not second guessed by a committee
  • They have their own pharmacies at their sites, but allow you to designate an outside pharmacy, and have prescriptions-by-mail
  • Co-pays are low because they do not have to answer to shareholders
  • Generally they are not-for-profit
I am now with Kaiser Permanente, and was with Sharp HMO in the past.  Since I am retired, the Kaiser Advantage plan has NO co-pay for the plan (filly covered by Social Security); just co-pay for visits, tests, and prescriptions.

"Why even insured Americans struggle to get mental health care" PBS NewsHour 11/1/2016


SUMMARY:  It's the first day of enrollment season for the Affordable Care Act.  But when it comes to mental health, even those with insurance struggle to get affordable care.  Special correspondent April Dembosky and Sheraz Sadiq of KQED meets a mom who faces misinformation, long waitlists for therapists and prohibitively expensive care for her son with autism and herself.

JUDY WOODRUFF (NewsHour):  Today is the first day of enrollment for 2017 under the Affordable Care Act, otherwise known as Obamacare.

But for some people who have health insurance, getting appropriate coverage can be a challenge.  More than 43 million Americans suffer from depression, anxiety or other mental health issues, but more than half never get help, even people who have health insurance.

From PBS station KQED in San Francisco, reporter April Dembosky and producer Sheraz Sadiq bring us a story of a single mother struggling to use her benefits to get treatment for herself and her son with autism.

APRIL DEMBOSKY, KQED San Francisco:  On a Sunday afternoon, Natalie Dunnege and her boyfriend, Russell Lifson, head to the park with Natalie's 13-year-old son, Strazh.

MAN:  Let's go.

APRIL DEMBOSKY:  He has autism, a developmental disorder that affects about one in 70 children in the U.S.

STRAZH:  You have strengths on one side of your brain and weaknesses on your other side, like, you know, controlling your emotions or this and that, you know? Strengths could be like coding or, you know, focusing on one thing for hours.

APRIL DEMBOSKY:  Each week, an applied behavioral analysis, or ABA, therapist comes to the house.

WOMAN:  Are you ready?

APRIL DEMBOSKY:  ABA therapy helps kids with autism learn life skills and how to control their temper.  Strazh and his therapist, Gabby Raders, create a schedule of carefully timed activities, so he can get better at transitions.

STRAZH:  This is the I.D., right, the identification with the enemy.  This is the width, height, speed X and speed Y.

APRIL DEMBOSKY:  Ending a favorite activity can trigger a meltdown.

STRAZH:  I can't do it.  No, I can't.

NATALIE DUNNEGE, Mother:  ABA therapy has helped my relationship with Strazh tremendously.  It's taught me how to communicate with him, when to back away, when to come in and help.

APRIL DEMBOSKY:  As a single mom working full-time, money is tight for Natalie.  She can only afford a few hours of ABA therapy a week.

NATALIE DUNNEGE:  I want my son to be as successful as possible, so every time I get a raise, I just increase ABA hours.

APRIL DEMBOSKY:  She has insurance through Blue Shield.  But getting mental health treatment has been really tough.

NATALIE DUNNEGE:  So, I went on the site.  And then you can see it says, like, doctors, facilities, dentists, nothing about where to find a therapist.  I called them, and they e-mailed me a list of providers.

APRIL DEMBOSKY:  Oh, so this is the list?

NATALIE DUNNEGE:  Mm-hmm.  Yes.  They all have a three-month waiting list.  And then, after the three-month waiting list, you have, like, two to eight weeks of intake.  And then hopefully you get approved.

This post first appeared on Mage Soapbox, please read the originial post: here

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HEALTH CARE - The Mental Health Gap


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