OUTLINE
Introduction
MHPAEA Act 1 was enforced to guarantee that the people seeking mental and drug abuse disorders receive the same coverage as those seeking medical and surgical care.
Research
The importance of the policy is evident from the fact that drug use and mental health disorders contribute to the development of more than 60 diseases and conditions that are covered by traditional medical plans, including cancer.
Public reaction for Mental Health Parity and Addiction Equity Act 1
The reaction from the public, the media and public service advocates was positive. However, the reaction from employers and medical plan providers was negative, because the change would widen their coverage burden.
The clusters affected by MHPAEA
The groups affected by the policy include the consumers of healthcare, employers and the providers of medical coverage.
Intended impact of the policy
The intended impact of the policy was that of expanding the coverage of mental health and drug use disorders, because they contribute to the healthcare burden being borne by the healthcare system.
Conclusion
The policy sought to improve access to care for the coverage of mental and drug use disorders. The recommendations made to improve the policy, include that it is important to eliminate ambiguities in the policy’s coverage.
Introduction: Social Problem related to MHPAEA 1
The MHPAEA Act 1 was enforced to guarantee that the American healthcare sector offers fairness and parity in the delivery of medical care benefits and those of individuals in need of care related to substance abuse effects or mental health problems. The Act was put in force starting 2008, to check that the individuals suffering from substance abuse and mental health-related disorders get benefits in the same way they would get benefits when seeking benefits related to surgical or medical care (Sarata, 2011). The limitations that the policy intended to address included those of a patient, whose plan restricted them in the area of accessing the care offered by a psychologist. Instead, it sought to ensure that, like they may be allowed to visit a gynecologist for medically-necessary procedures with no limitation to number of visits, they should enjoy the same freedom for visits made to a psychiatric facility. However, there is the importance of highlighting the fact that it does not mandate suppliers of coverage to allow access for addictions and mental issues. The indication of this area of limitation is that the conditions requiring the mental or addiction services should be similar or comparable to those of the surgical or the medical areas covered by such a plan (Sarata, 2011). For example, for an individual suffering from an addiction disorder that influences the outcomes of medical care, the disorder should be covered. The rationale is that the plan should cover the range of areas that can prevent or solve the array of problems. The scope of the Act is enforceable to the coverage of many of the providers offering commercial-type care plans and in the health sector as well as the general market.
Research: the importance of comprehensive benefits coverage
The social problems of addictions and adverse substance use comprise the worst health problem that affect American on a large scale, contributing to major expenses that could be avoided through the control of the root causes. The main substances that are the main contributors to the problem include alcohol and tobacco, among another wide array of drugs (CASA, 2012). The problem of addiction is reported among a number that is higher than that reported to suffer from conditions like diabetes, coronary conditions and cancer, which are also major healthcare problem areas in the US. The population reported as adversely affected by the problem of addiction comprises about 20 percent of the entire population (CASA, 2012). Further, the group found to be highly vulnerable to the problem comprised about a third of the entire population (CASA, 2012). For this second group, despite not being addicted, their use of drugs predisposes them to safety and health risks. The failure to treat the problem of addictions and substance use is the main cause of more than 60 other medical conditions that are covered under the medical benefit plans of ordinary plans, including respiratory conditions, coronary conditions, cancers, ulcers and pregnancy complications among others (Centers for Disease Control and Prevention, 2008, p. 1226).
The solution to the wide array of secondary diseases and conditions lies in the incorporation of these problems into the coverage of traditionally covered medical and surgical services. Within the traditional system of care, the risks emanating from substance use and addiction can be resolved through the diagnosis of the problems and subjection of the victims to proven interventions (Sarata, 2011). For example, addictions can be managed and totally eliminated using evidence-based psychosocial and medical procedures. Unfortunately, as the root causes, to many of the medical problems treated in the US, the system has not been open to prevent the risky uses of drugs and the treatment of addictions. For example, it has been reported that, only about 10 percent of the patients seeking treatment for drugs and alcohol-related conditions are offered any treatment that can eliminate the problem and the risks that emanate from them (CASA, 2012).
Public reaction for Mental Health Parity and Addiction Equity Act 1
The reaction offered to the legislation among the advocates of substance use and mental problems treatment was largely positive (Gauthier, Ray & Alexandrei, 2010). However, they expressed some reservation, in relation to the ambiguity surrounding the policy. The reservations made highlighted that the policies were mainly ambiguous, which may complicate the service seeking of patients and also the willingness of service providers to cover a large variety of coverage disorders. In particular, the advocates of the two lines of healthcare covered by the policy sought to gain a platform that would increase the specificity and the adoptions of the conditions needed to favor service delivery. The reaction of the employers and insurers affected was different. The main issues highlighted through their reactions included that the policy did not allow for self-determination and high levels of flexibility in the management of the costs of service delivery (Gauthier, Ray & Alexandrei, 2010).
The media’s reaction was totally different; it reflected a positive reception of the service provision system. For example, one article by the New York Times reported that the policy was a victory for the Obama administration, in a fight that had taken years (The Editorial Board, 2013). Further, the post highlighted that the policy would have positive effects, mainly because the people that were not able to seek the medical care offered in the two target areas will receive it. The article appraised the policy, because it would allow the more than half of the number of cases, who are never able to seek help due to financial implications to get the care needed to propel them on a new track of health benefits (The Editorial Board, 2013). A similar reaction was manifest from a Washington monthly article. The article applauded the inclusion of drug use and mental healthcare in the insurance system, despite highlighting that the government had not channeled enough efforts towards the prevention and the treatment of the problems caused by drugs (Humphreys, 2014).
The clusters affected by MHPAEA
The first group which is affected by the policy is the consumers of medical health insurance. This is one of the groups affected directly by the policy, in that it will allow them access to care services in the areas of substance use and mental problems. The implications of the policy include that this group will benefit from the expansion of coverage to cover the benefits of the areas of care that were not covered under traditional plans (Sarata, 2011). The second groups affected are the organizations offering coverage services. The effects felt by this group includes that, it will no longer impose limitations on the patient’s access to mental or substance abuse care. Traditionally, patients would be required to get these services in a more restricted way, where – for example – the patient would be restricted to five visits to a psychiatrist, but still make as many visits as needed to medical care facilities (Sarata, 2011).
Intended impact of the policy
The fundamental goals of the policy was that of increasing the fairness of accessing care benefits for substance use and mental health needs, to the levels offered for surgical and medical care. This effect is applicable to the medical plans that are offering the options of care for mental and substance use needs, and the precondition is that the level of service delivery should be similar to that of medical services (Sarata, 2011). However, the policy does not compel the plans that did not offer the services traditionally, to start offering services in the new area. In real-world-care settings, for a plan that allows the user to seek medical services for an unlimited number of times, it is expected that the same treatment will be extended to those seeking services on mental and substance use disorders. One of the supporting groups was US policymakers (congress). It championed for the policy as enforcement for another program, starting in 2008.
The policy has been one in the chain of the laws formulated to widen the availability of care for the mentally ill in the US. The public and public health advocacy groups are the second groups supporting the policy. These groups have been behind the policy, pushing for its endorsement, and have also expressed their support for the previous policies that took the same position as the embattled policy (Segal, 2010). The first groups that has been objecting the law has been the medical insurers and employers, particularly those affected by the widened scope of insurance service provision. The main reason for the opposition was that, mental and addiction disorders should not be covered as a spectrum. This group has expressed revolt against the policy, based on the grounds that addiction care and medical health should not be funded using the traditional system of care financing (Segal, 2010).
Conclusion
MHPAEA Act 1 was the legislation endorsed by the US congress in 2008, as a model framework for supporting the widening of the delivery of care services for addiction disorders and mental issues. The importance of the Act has been exposed by the review of the contribution made by addiction disorders and mental issues in the development of more than 60 healthcare conditions that are covered under the traditional financing framework. The conditions caused by the health issues in question include cancer and coronary conditions. Positive reaction came from the public, public care advocates and the media. However, the reaction from employers and insurers was primarily skeptical, because they would need to pay more. The policy is important because it can lessen the depth of other mental problems, especially those that are caused by the pair of problems. The suggestions that may improve this policy include that healthcare providers together with policy makers, should monitor future admissions, so as to see whether the policy is impactful. Currently, it is important to eliminate the ambiguities in the policy, which has left it unclear for the groups it is serving and the conditions it was fashioned to address.
References
Centers for Disease Control and Prevention. (2008). Smoking-attributable mortality, years of potential life lost, and productivity losses: United States: 2000-2004. Morbidity and Mortality Weekly Report, 57 (45), 1226-1228.
Gauthier, P., Ray, C., & Alexandrei, K. (2010). Old game, new rules: How will payers react to new limits imposed by parity regulations? Behavioral Healthcare. Retrieved from:
http://www.behavioral.net/article/old-game-new-rules?page=show
Humphreys, K. (2014). Another Day, Another Misinformed Article on Obama’s Addiction Treatment Record. Washingtonmonthly. Retrieved from:
http://www.washingtonmonthly.com/ten-miles- square/2014/09/another_day_another_misinforme051917.php#
Sarata, A. K. (2011). Mental health parity and the Patient Protection and Affordable Care Act of 2010. Washington (DC): Congressional Research Service.
Segal, E. (2010). Social Welfare Policy and Social Programs: A Values Perspective (2nd Edition). Boston, Massachusetts: Cengage Learing.
The National Center on Addiction and Substance Abuse (CASA). (2012). Addiction medicine: Closing the gap between science and practice. New York: Author.
The Editorial Board. (2013). Equal Coverage for the Mentally Ill. NY Times. Retrieved from: http://www.nytimes.com/2013/11/09/opinion/equal-coverage-for-the-mentally- ill.html?emc=eta1&_r=1&
