Magazine article Behavioral Healthcare Executive

Promoting Universal Coverage

Magazine article Behavioral Healthcare Executive

Promoting Universal Coverage

Article excerpt

Even though many states are considering or implementing universal health insurance initiatives, the economic environment will make them a tough sell in state capitols. Hence, it is very important to be able to make clear arguments in favor of universal coverage.

A principal motivation is the recognition that the usual form of Healthcare for uninsured persons - the emergency room - is among the most expensive offered to any segment of our population. For an uninsured person with a mental illness, the ER has become the new inpatient ward. Stories of people spending five to six days in ERs are becoming common, as other alternatives simply are not available.

A second, related, factor is the realization that an uninsured person has no regular provider - primary care or mental health. No one is available to coordinate care or facilítate early interventions so that the ER is not needed, but as a last resource.

State universal coverage initiatives vary considerably. Some are truly universal, seeking to provide insurance for everyone. Others do not claim to be universal but seek to expand coverage to an additional group (e.g., persons between 200 and 300% of the federal poverty level). So although not truly universal initiatives, they do aim to make healthcare coverage more widespread. Universal coverage doesn't mean the same type of health insurance benefits for everyone.

Recently, the National Alliance on Mental Illness and the National Council for Community Behavioral Healthcare released a landmark paper, Coverage for All: Inclusion of Mental Illness and Substance Use Disorders in State Healthcare Reform Initiatives. This report has focused the mental health and substance use care fields' attention on state universal coverage initiatives and the mental health and substance use care benefits they aim to provide.

The paper highlights some startling data. Fully one-third of uninsured persons have a mental or substance use condition, and fully one-third of persons with these conditions have no health insurance. Looked at either way, these figures are double the uninsured percentage (17%) in the general population.

Because these numbers are so large, an urgent need exists for us to promote state universal coverage initiatives vigorously. And when we promote them through testimony, advocacy, or other means, we need to argue strenuously for good mental health and substance use care benefits.

Minnesota has an exceptional model to emulate. …

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