IT professionals and writers alike need a finely tuned bullshit antenna coupled with a high gain filter.
Not long after Obamacare was passed I was driving somewhere listening to NPR and one of the regular shows had some supposed expert spouting off that forcing insurance companies to cover mental health was rather pointless since most mental health professionals don’t accept insurance.
The bullshit warning flags went up.
I spent a bit of time searching for a transcript of the show, but couldn’t find the exact show with the exact quote. One has to be careful listening to NPR these days because much of it is propaganda from the foreign countries of California and New York trying to meddle with/influence the election. They’ve learned a trick or two from Russia.
I did, however, find quite a few NPR segments listed where various versions of the same statement were put forth. It is further evidence that the foreign country known as California has been trying to influence the election. Let’s watch the grass pass through the bull and become shit shall we?
After a bit of digging I stumbled onto the show which appeared to provide the grass. Here are two quotes from it which are completely contradictory.
Klein doesn’t accept insurance. In fact, nearly half of therapists in California don’t take insurance, according to a recent survey from the California Association of Marriage and Family Therapists. The same is true of psychiatrists. There are two reasons why, Klein says.
Six different companies told Horowitz their networks were full.
The second quote is later in the link and part of the tale about one mental health professional’s attempt to become a provider on any health network. He applied at to ten different networks, six told him they were full, one added his business to the provider list, but never added any of the professionals working there so they couldn’t actually see any patients which were referred. I didn’t read enough to find out about the other three.
This person’s story told me what I suspected was the truth all along. Many health insurance companies didn’t want to provide mental health coverage so they added a bunch of businesses to make their network look full, but never added any practitioners so they would never have to pay a claim. This speaks loudly about the total lack of enforcement and follow up provided by the federal government.
The first quote is the grass which was eaten by the bull. It started showing up on Fox News and in their typical make shit up fashion suddenly became a study which represented America in its entirety even though it was a study conducted in the foreign country of California. While I was searching for the NPR show I remembered I also stumbled onto a psych blog which seemed to have digested the Fox News version. (Cattle do have multiple stomachs.) Here are a couple of quotes from it.
But what might matter to you more is how few psychiatrists accept private insurance or Medicare. According to a recent study, that number is at a surprising 55 percent — and dropping.
Probably not. The researchers note that “low reimbursement has been cited as a reason why physicians do not accept insurance. However, reimbursement rates for office-based psychiatric treatment are similar to those for office-based medical evaluation and management, such as primary care services.”
You can see the continued digestion of the Fox News spin in the first quote. The second quote almost had a ring of truth to it though. I can easily see insurance companies which never provided mental health coverage in the past trying to treat these professionals like every other doctor.
This bullshit signal sat in the back of my mind all this time. Finally, I went to see some friends shortly after New Years 2018. The wife in this couple is a mental health professional so I asked her to call bullshit on this or call me a fool. She told me when she was starting out the other professionals she knew in the area told her to get on as many insurance boards as possible because it was the only way to make it, so she did. She also said she did not know of any mental health professionals in the area which did not accept insurance. Given the professional group(s) she belonged to, there wasn’t a single member which didn’t accept insurance.
I did not think to ask about Medicare and Medicaid. I would assume, given the historically abysmal reimbursement rates of those two programs that some would avoid them if possible. I know of physicians which don’t accept them for that very reason. It is true, many who need mental health care the most and might well be at the center of the next mass tragedy without it, won’t be able to get it until Medicare and Medicaid up the amounts they are willing to pay providers enough to make the service available. If someone were to tell me there is a shortage of mental health professionals, as long as they are geographically specific with the statement, I would believe that. Most small towns aren’t going to have a psychiatrist set up shop. Many small towns have neither a dentist nor a doctor. There are five such towns within a 20 minute drive of me. Some of them have neither a gas station nor grocery store as well.
So now we see the cow pie laying in the pasture. In an effort to influence the election the foreign country of California conducted a study and published it so it could be spun as representative of all America when it was not. In that foreign country where a $2 million home is considered a “starter home” and anything less than a $100K car is something one cannot be seen driving, it’s understandable that providers can’t make it on an American wage.
In a country where Google execs shoot heroin on their yacht with a prostitute while the wife and kids are at home, it is completely understandable that there are plenty of people with tons of cash lying around to pay out of pocket for mental health care they don’t want the company or silicon valley to find out about.
In the rest of America, this is not the case.
Given HMO atrocities in the past I would gladly cede the point that many insurance companies are papering over their provider list, adding companies but not authorizing any professionals so they can still sell insurance without having to pay any claims. To me that is a given. Any company which would kill patients for profit should have no problem introducing some “clerical errors” to avoid paying claims.
The initial claims about the survey representing America in general, however are
Digestion complete.
