| Uneven Supply | | | | like any other medical condition, thus leading to a |
| Psychiatrists are not spread Nationally evenly. Across | | | | greater availability of services for people with mental |
| the country, the psychiatrist per .1 million population ratio | | | | health problems. |
| is about 16.5 per one hundred thousand. That ratio, | | | | Cost |
| which reaches its high in the new england state of | | | | The invisible costs of mental illness is incalculable, but |
| Massachusetts. at 31.1 per 100,000, bottoms out at 4.6 | | | | the monetary one is not. According to a report by the |
| per one hundred thousand in Idaho. Counter-balancing | | | | U.S. Surgeon General's office, in 1996 the United States |
| the five states with the highest ratios MA, NY, PA, CA, | | | | spent more than 99 billion USD for the direct handling |
| and TX are the five states with the lowest ratios: | | | | of mental disorders. In 1990, the most recent time |
| Idaho, Wyoming, South Dakota, North Dakota, and | | | | period for which estimates are obtainable, the indirect |
| Alaska. The Western states have the lowest per | | | | cost of all mental illness was at seventy nine billion |
| capita supply. | | | | dollars, with most of that amount coming from loss of |
| | | | productivity due to premature death, incarceration and |
| In addition to the predicament are the vagaries of | | | | time spent by family members caring for the ill. |
| coverage providers practices and public health care | | | | Primary Care Alternative to Psychiatry |
| programs. Some psychiatrists will only see patients | | | | Primary care physicians are making an effort to |
| with private insurance. Others, who are employed by | | | | compensate for the insurance gap by discovering how |
| regional behavioral health organizations, may only | | | | to care for such patients on their own. Because those |
| provide services for individuals on the states Medicaid | | | | primary care physicians know they lack anywhere to |
| program. Arizona Health Care Cost Containment | | | | send such patients, and the individual is likely to keep |
| System will not see patients who have private | | | | returning to them for care anyway, it behooves the |
| insurance. And, there are some mental health | | | | doctors to expand their skills to cover these kinds of |
| physicians who will not accept any insurance policy | | | | problems. However, many insurers refuse to reimburse |
| plans. | | | | primary care physicians for mental health services and |
| Many private health insurance plans will only pay for a | | | | only cover such services if provided by a psychiatrist. |
| limited amount of mental health care. Mental health | | | | Even with the health bill ultimately signed into law its |
| problems are singled out by insurance coverages, and | | | | effect on our health care is not established. By 2014 |
| ongoing care may not be covered despite persistent | | | | there will be an increase in the enrollment into health |
| need. If a patient is still in need of services for | | | | care insurance programs. This increase in intensity |
| depression, for instance, but their plan only allows for 3 | | | | when, combined with the long term aging of the |
| mental health visits per calendar year, they have no | | | | populace, should push demand for services and |
| other options but to either discontinue care or pay for | | | | therefore cost higher. However, no one yet knows |
| the care by themselves. This is a major topic for | | | | what will happen to remuneration rates from |
| physicians in AZ who feel that mental illnesses should | | | | government funded insurances and this new program. |
| be covered by insurers just like any other disease. For | | | | The question is will there be a cut of reimbursement |
| example, insurers normally will pay for as many | | | | amounts for different specialties by Medicare and this |
| outpatient visits and inpatient care needed to | | | | new program that may contrarily become a |
| successfully manage a diabetic patient, but the same | | | | decreasing factor of the income of all specialties |
| insurer will limit their benefits despite the requisite for | | | | including Psychiatry, its related specialties, and |
| continual care for patients who indeed have a mental | | | | subspecialties. |
| health disorder. | | | | Clearly the Obama administration has its hands full. We |
| While some of the mental health requirements of | | | | are getting older and there are fewer young people to |
| patients can be taken care of by psychologists, some | | | | carry this growing financial burden. The Sins of the |
| patients may be too sick and in need of an MD or DO | | | | Fathers..... |
| who can prescribe pills, something a psychologist does | | | | Sources: The Centers for Disease Control and |
| not do. Over the years, physicians and mental health | | | | Prevention, School of Health Management and Policy |
| supporters have strongly lobbied for mental health | | | | at the W. P. Carey School of Business. |
| parity that insurance companies treat mental illnesses | | | | |