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UnitedHealth's Playbook for Limiting Mental Health Coverage

93 points by cratermoon 2y ago

anon291 2y ago
[flagged]
- WesternWind 2y ago
  The entire premise of insurance is that people get care for their medical issues. Mental health issues are medical issues; just because they manifest in terms of behavioral and thinking changes doesn't make them any less so. Mental Health coverage does cover therapy, and therapy of various sorts is effective to treat or ameliorate a number of mental health issues, but it also covers psychiatric medication. Also mental health coverage covers people's kids and dependents, not just them, your focus on the policy holder is a little narrow, I think.
  - anon291 2y ago
    > Also mental health coverage covers people's kids and dependents, not just them, your focus on the policy holder is a little narrow, I think. Right, but as people are more and more likely to be single, more and more people are policy holders. This is not a situation where you always have a spouse with insurance or something. > Mental Health coverage does cover therapy, and therapy of various sorts is effective to treat or ameliorate a number of mental health issues As I said. mental illness is on the rise. We could treat all these issues and spend for it. Or we could try to trace root causes (I know people are working hard on this). The latter seems the more useful method.
- nextaccountic 2y ago
  > For one thing, the entire premise of insurance is that the policy holder is sound of mind. Why?
  - anon291 2y ago
    Because they have to be sound of mind enough to hold the policy to begin with. Also most health insurance policies (and socialized policies for that matter) require adherence to a particular protocol, to qualify for treatment, which is difficult for those who are addled.
- diob 2y ago
  I'm not sure what you're trying to say, at all.
  - anon291 2y ago
    1. Mental illness is on the rise. Causes are uncertain 2. It's not clear the cause is medical, unless you classify almost all human experience as a medical event (hence the parallel with marriage). 3. Insurance depends on people being of sound mind. Especially with what we have today, you have to be of sound enough mind to administer it all. 4. Maybe health insurance is not the right approach to mental problems, and maybe no insurance is. We need some other way. I don't know that way.
    - deleted 2y ago
      [deleted]
    - righthand 2y ago
      > Maybe health insurance is not the right approach to mental problems, and maybe no insurance is. We need some other way. I don't know that way. Insurance is the method of paying for healthcare. We have insurance because healthcare is expensive. So insurance wouldn’t be necessary if we would lower costs by providing universal healthcare like modern countries. You’re touching on the right idea: Mental healthcare should be preventative not something applied after we discover an illness. Changing any of it starts with educating people foremost so they can empower themselves.
- add-sub-mul-div 2y ago
  [flagged]
deleted 2y ago
[deleted]
lenerdenator 2y ago
It’ll be interesting to see what motivations the murderer of their CEO had. A lot of potential motivations could be seen as parties being unwilling to participate in the marketplace of sane solutions.
jmyeet 2y ago
Mental health care is particularly difficult from an insurance perspective. You'll often find that many providers won't even taken insurance. Why? Because insurance requires a diagnosis, a treatment plan and ultimately a resolution. That's an awful lot of paperwork, whatever your condition is might not be covered and usually people need ongoing mental health care, not just dealing with an acute diagnosis. Some years ago Foxconn put nets around their building because too many people were jumping off. 17 veterans a day take their own life. Medical residency is arguably a risk factor for suicide. More broadly we have declining material conditions where people lack a sense of safety and security because they're living paycheck-to-paycheck. They're now working multiple jobs, some of which get propagandised as "side hustles". Why? Because an indebted worker bee working multiple jobs generates more profits. And just now I read that one insurer is putting a time limit on anesthesia coverage for surgery [1]. We have parasitic middlemen (ie insurance companies) whose entire business model is to take money for health care and then deny providing that health care any way possible. This, like so many other things, is an economics problem. This is capitalism. [1]: https://www.levernews.com/big-insurer-sets-time-limits-on-anesthesia-coverage-during-surgeries/ https://www.levernews.com/big-insurer-sets-time-limits-on-an...
- pyuser583 2y ago
  Limiting therapy to once a week seems reasonable. Even for patients in an inpatient program, more than once a week one-on-one is not normal. I dislike insurance companies, and this one in particular has a deserved reputation. But show me the foreign country that regularly provides more than 30 sessions/8 months with a highly qualified counselor. I’ve worked with young people at risk for suicide. The most important advice is to remove access to death-dealing mechanisms: firearms, poisons, high-ledges, etc. The more time someone in crisis has to “think again” the less likely they are to kill themselves.
- sbalough 2y ago
  I live in the US and don’t disagree with your perspective. I am genuinely curious if the average American is better or worse off in terms of mental health than 30 or 50 years ago. My guess is that people just described the symptoms differently in the past - like alcoholism or being mad most of the time. I’m not saying the situation today is good, but does it keep sucking less over time?
sdsdc 2y ago
[flagged]
sdsdc 2y ago
[flagged]
righthand 2y ago
Mental health is and has been our county’s biggest issue and has lead us to our current injunction. If we cannot improve our healthcare system we will remain addicted, anxiety riddled, divided, and live more and more in disillusion. It is a tragedy the way we turn our backs on health and label healthcare as a stigma and allow it to be run as a grift on the public and people immigrating here.
bhaney 2y ago
Yeesh, that's a risky bet. Saves them some money on mental health coverage for sure, but it's only a matter of time before someone turns murderous because of their lack of access to care. Oh well, it probably won't ever affect anyone at United.
- sbalough 2y ago
  Seemed like a hit job. Most likely the public and especially poorer folks will just keep getting screwed since their communities will most likely be exposed to armed unstable types.
- RGamma 2y ago
  Killing the CEO is like in the movie "I care a lot" which is about a sociopath business ripping old people off. Wonder whether there was some inspiration from that.
slt2021 2y ago
[flagged]
- deleted 2y ago
  [deleted]
deleted 2y ago
[deleted]
ChrisArchitect 2y ago
Some more discussion perhaps: https://news.ycombinator.com/item?id=42317968 https://news.ycombinator.com/item?id=42317968
euroderf 2y ago
Decisions by corporate paper-pushers can kill. Might be deeply upsetting to some.
OutOfHere 2y ago
[flagged]
kotaKat 2y ago
Meanwhile, at the same time, I was receiving emails as a UHC policyholder — “not intended to imply the recipient has a specific disease or condition” that heavily seemed to imply I was having mental health crises all the time. First, “Have you been avoiding activities that you used to enjoy?”. Kinda out of left field to get but fine. Couple weeks later, “With support, you can live an even healthier life” with a suggestion to watch some yoga video they sent me. One day later: “Stressed? Confidential help starts with a phone call” and UHC heavily suggesting I reach out to EAP. All of these emails were still sent “not intended to imply” anything about my health. Right. I’m sure, UHC.

93 points by cratermoon 2y ago

anon291 2y ago

[flagged]

WesternWind 2y ago
The entire premise of insurance is that people get care for their medical issues. Mental health issues are medical issues; just because they manifest in terms of behavioral and thinking changes doesn't make them any less so. Mental Health coverage does cover therapy, and therapy of various sorts is effective to treat or ameliorate a number of mental health issues, but it also covers psychiatric medication. Also mental health coverage covers people's kids and dependents, not just them, your focus on the policy holder is a little narrow, I think.
- anon291 2y ago
  > Also mental health coverage covers people's kids and dependents, not just them, your focus on the policy holder is a little narrow, I think. Right, but as people are more and more likely to be single, more and more people are policy holders. This is not a situation where you always have a spouse with insurance or something. > Mental Health coverage does cover therapy, and therapy of various sorts is effective to treat or ameliorate a number of mental health issues As I said. mental illness is on the rise. We could treat all these issues and spend for it. Or we could try to trace root causes (I know people are working hard on this). The latter seems the more useful method.
nextaccountic 2y ago
> For one thing, the entire premise of insurance is that the policy holder is sound of mind. Why?
- anon291 2y ago
  Because they have to be sound of mind enough to hold the policy to begin with. Also most health insurance policies (and socialized policies for that matter) require adherence to a particular protocol, to qualify for treatment, which is difficult for those who are addled.
diob 2y ago
I'm not sure what you're trying to say, at all.
- anon291 2y ago
  1. Mental illness is on the rise. Causes are uncertain 2. It's not clear the cause is medical, unless you classify almost all human experience as a medical event (hence the parallel with marriage). 3. Insurance depends on people being of sound mind. Especially with what we have today, you have to be of sound enough mind to administer it all. 4. Maybe health insurance is not the right approach to mental problems, and maybe no insurance is. We need some other way. I don't know that way.
  - deleted 2y ago
    [deleted]
  - righthand 2y ago
    > Maybe health insurance is not the right approach to mental problems, and maybe no insurance is. We need some other way. I don't know that way. Insurance is the method of paying for healthcare. We have insurance because healthcare is expensive. So insurance wouldn’t be necessary if we would lower costs by providing universal healthcare like modern countries. You’re touching on the right idea: Mental healthcare should be preventative not something applied after we discover an illness. Changing any of it starts with educating people foremost so they can empower themselves.
add-sub-mul-div 2y ago
[flagged]

deleted 2y ago

[deleted]

lenerdenator 2y ago

It’ll be interesting to see what motivations the murderer of their CEO had. A lot of potential motivations could be seen as parties being unwilling to participate in the marketplace of sane solutions.

jmyeet 2y ago

Mental health care is particularly difficult from an insurance perspective. You'll often find that many providers won't even taken insurance. Why? Because insurance requires a diagnosis, a treatment plan and ultimately a resolution. That's an awful lot of paperwork, whatever your condition is might not be covered and usually people need ongoing mental health care, not just dealing with an acute diagnosis. Some years ago Foxconn put nets around their building because too many people were jumping off. 17 veterans a day take their own life. Medical residency is arguably a risk factor for suicide. More broadly we have declining material conditions where people lack a sense of safety and security because they're living paycheck-to-paycheck. They're now working multiple jobs, some of which get propagandised as "side hustles". Why? Because an indebted worker bee working multiple jobs generates more profits. And just now I read that one insurer is putting a time limit on anesthesia coverage for surgery [1]. We have parasitic middlemen (ie insurance companies) whose entire business model is to take money for health care and then deny providing that health care any way possible. This, like so many other things, is an economics problem. This is capitalism. [1]: https://www.levernews.com/big-insurer-sets-time-limits-on-anesthesia-coverage-during-surgeries/ https://www.levernews.com/big-insurer-sets-time-limits-on-an...

pyuser583 2y ago
Limiting therapy to once a week seems reasonable. Even for patients in an inpatient program, more than once a week one-on-one is not normal. I dislike insurance companies, and this one in particular has a deserved reputation. But show me the foreign country that regularly provides more than 30 sessions/8 months with a highly qualified counselor. I’ve worked with young people at risk for suicide. The most important advice is to remove access to death-dealing mechanisms: firearms, poisons, high-ledges, etc. The more time someone in crisis has to “think again” the less likely they are to kill themselves.
sbalough 2y ago
I live in the US and don’t disagree with your perspective. I am genuinely curious if the average American is better or worse off in terms of mental health than 30 or 50 years ago. My guess is that people just described the symptoms differently in the past - like alcoholism or being mad most of the time. I’m not saying the situation today is good, but does it keep sucking less over time?

sdsdc 2y ago

[flagged]

sdsdc 2y ago

[flagged]

righthand 2y ago

Mental health is and has been our county’s biggest issue and has lead us to our current injunction. If we cannot improve our healthcare system we will remain addicted, anxiety riddled, divided, and live more and more in disillusion. It is a tragedy the way we turn our backs on health and label healthcare as a stigma and allow it to be run as a grift on the public and people immigrating here.

bhaney 2y ago

Yeesh, that's a risky bet. Saves them some money on mental health coverage for sure, but it's only a matter of time before someone turns murderous because of their lack of access to care. Oh well, it probably won't ever affect anyone at United.

sbalough 2y ago
Seemed like a hit job. Most likely the public and especially poorer folks will just keep getting screwed since their communities will most likely be exposed to armed unstable types.
RGamma 2y ago
Killing the CEO is like in the movie "I care a lot" which is about a sociopath business ripping old people off. Wonder whether there was some inspiration from that.

slt2021 2y ago

[flagged]

deleted 2y ago
[deleted]

deleted 2y ago

[deleted]

ChrisArchitect 2y ago

Some more discussion perhaps: https://news.ycombinator.com/item?id=42317968 https://news.ycombinator.com/item?id=42317968

euroderf 2y ago

Decisions by corporate paper-pushers can kill. Might be deeply upsetting to some.

OutOfHere 2y ago

[flagged]

kotaKat 2y ago

Meanwhile, at the same time, I was receiving emails as a UHC policyholder — “not intended to imply the recipient has a specific disease or condition” that heavily seemed to imply I was having mental health crises all the time. First, “Have you been avoiding activities that you used to enjoy?”. Kinda out of left field to get but fine. Couple weeks later, “With support, you can live an even healthier life” with a suggestion to watch some yoga video they sent me. One day later: “Stressed? Confidential help starts with a phone call” and UHC heavily suggesting I reach out to EAP. All of these emails were still sent “not intended to imply” anything about my health. Right. I’m sure, UHC.