The Obama-Biden Transition Team has asked individuals from across the country to host Community Health Care Discussions during the last two weeks of the year as a way to hear what everyday Americans are saying about Health Care in our country.
I hosted such a meeting last night, to which were invited several Bessemer neighbors as well as health professionals including a nurse manager in mental health, the Dean of the School of Public Health at UAB and a faculty member from the School of Health Professions at UAB. I purposely kept the number of people low to insure that everyone would have a chance to take part in the discussion.
I will be sending a report to the Transition Team which can be used in crafting policy for the new administration.
But here are a couple of things we learned. It's not news that the "system" is broken, but the degree to which it is broken and the ways in which this affects patient care was surprising.
One problem had to do with insurance coding and billing and how this affects a doctor's scheduling.
It boils down to: you make an appointment to see a doctor about problem A, and before your scheduled appointment time you develop problem B. When you arrive for your appointment the doctor refuses to address problem B and requires that you schedule another appointment, which may be two weeks or more down the road. What this does to the health of America is it keeps this person (or lots of people, assuming this is happening all over) sick or in pain for an additional two weeks. Or, of course, their condition could worsen.
In other words, the "Health system" is contributing to a "sick nation." It is contributing to people being off from work. It is costing Americans more.
And that is just one of the problems.
The other issue we discussed was mental illness and how stigma affects the treatment people receive. The stigma associated with mental illness can result in people ignoring symptoms or pretending they don't exist, and avoiding treatment.
Mental illness stigma exists for several reasons. One is that mental illness is thought by some to be the result of a choice or action of the individual and is perceived to be on a different level than physical illness. In reality, mental illnesses are complex and are due to physical changes in the brain, with or without a genetic component.
Mental illness should be treated with the same degree of recognition and respect as physical illnesses. The American Public should be educated about mental illnesses, and not from commercials on TV about drugs used to treat them. Doctors as well, should be educated and should focus on the mental health of their patients as well as their physical health.
Depression, for example, affects people's ability to work in a huge way, yet often physicians ignore or don't take the time to question patients in order to pick up signs that there may be a problem.
Then there is this: 1 in 5 young Americans have a personality disorder, according to a recent study. But less than 25% get treatment.
These disorders include obsessive or compulsive tendencies (different from OCD) and anti-social disorders (which can lead to violence) and paranoid behaviors, all of which can interfere with day to day functioning. That's 1 in 5 of our future leaders.
Mental health parity is the first step in reducing the stigma associated with mental illness.
Parity would require insurance plans to treat mental health patients on par with those who have physical ailments. No more higher copays or deductibles for the mental health treatments. No more limits on visits to the doctor that differ from the caps for other patients.
A mental health parity bill was tacked on to the big bailout passed in October, but that bill is not complete and parity involves more than just payments, it also involves doctor's attitudes and education. But...it's a start.