I have several gripes but I’ll limit myself to two. She “educates” by offering what she acknowledges “are extreme examples”. (At least she’s not recycling that 10.5% statistic. We (Dawn Farm) have talked about that frequently. Parity or no parity, the days of extended hospitalizations payed for by insurance companies are gone.

If anything, I think it’s likely that parity could starve the kinds of programs she’s rightly concerned about. Addiction treatment providers have been far too quick to blame managed care for their demise and fail to take responsibility for these excesses and for failing to measure outcomes.

However, she’s painting a pretty unbalanced picture. These excesses are what set the stage for managed care. Maia Szalavitz has written a follow-up post on parity. The period she’d reporting on was a characterized by excesses in many areas of health care. How about the changes in prescribing practices with antibiotics. that was not different to mental health or addiction treatment.

Second, as I pointed

out earlier that week, her concerns about those excesses being recreated whether parity is passed are unfounded. She’s indisputably exact that there is a history of over-diagnosis and over-treatment of addiction. Where parity has been enacted, insurance companies have implemented tight managed care protocols to limit costs. Consider the reductions in hospital stays for all conditions and procedures. Consider the reductions in the numbers of hysterectomies and C-sections. First, some historical context might be helpful. (Although, I must confess that, in 13 years of practice and thousands of clients, I don’t think I’ve ever met a client who was in the kind of boot camp she writes about.) I suspect that citizens send their kids to boot camps and programs like them at their own cost considering their insurance company does not supply adequate care and hospital-based psych units are far too expensive. Parity might create circumstances where parents aren’t so desperate for help (any help) that they send their kids to these programs.

Original post by Jason Schwartz