President Requires Insurance Coverage for Mental Illness and Addiction


President Obama has used his mighty law-making pen to require all insurance carriers to provide coverage for mental health treatment and addiction in the same manner as they do physical illnesses.

This is part of a package of regulations designed to stop the mass shootings this country has experienced. The proponents of this action say that it will not result in a large increase in the cost of health care coverage. I do not believe that. I think it will cost a huge amount.

I have unhappy family experience with addiction, and I don’t have much hope that this measure will curb the plague of drug addiction and alcoholism that is warping our society. I’ve seen what happens when people are sentenced to drug treatment by the courts. I’ve also seen what happens when their family persuades them to go to an expensive treatment program.

The drug treatment plan my family member attended because of court order was a scam. The family member was supposed to be in residence 24/7 as part of their treatment, but they came and went as they chose. There was no effort to enforce the rules or kick this person out. The treatment facility was raking in government money and not even enforcing its own rules with people that were sentenced to it by the courts.

I’ve also had unhappy experience with an expensive (very expensive) private treatment program. I went to meetings for family members and did the whole nine yards. The place was full of doctors, police, and others who had been sent there in order to keep their professional standing. They were not sorry. About anything.

The viewpoint expressed in meetings was that their families, friends and colleagues were … I can’t repeat the language … for being angry with them for the things they’d done in their addictions. These were privileged people, doing the doh-si-doh required for them to keep their license.

My family member went through the program and then got out and went right back to using.

On the other hand, I have seen people stop using and rebuild their lives and reclaim their souls just by going to the entirely free and voluntary Alcoholics Anonymous program.

No drug treatment program will help people who don’t want to be helped, and if someone really wants to stop, the expensive programs aren’t necessary. Also, the ones I’ve seen are overpriced — massively overpriced — and catering to their clientele more than they are treating them. Many of them are just raking in government money and processing people with no real concern about treating them.

I am concerned that the mental health care that will come about as a result of this ruling will be somewhat the same.

We have taken the idea of “treatment” as a panacea for ghastly behavior to the max. I have read that some of the young men who have killed large numbers of people in these mass murders were mentally ill. However, most of them were also from privileged well-to-do families with access to any care they needed. In fact, at least one of them that I’ve read about was under treatment at the time he committed the murders.

I am not opposed to mental health care for mentally ill people. In fact, I support it.

But I think that using this treatment as a catch-all cure for what are much deeper social ills will not and can not work. I think it is dodging the real issues, which are complex and require more of us as a society than just paying for some “expert” to fix people for us. I also think that simply handing over the money without stringent requirements about the quality of care is a mistake.

Drug addiction treatment, in particular, is, at least in my experience, over-priced and under-effective unless the person receiving the treatment truly wants to change and is motivated to endure what it takes to do that. In that case, free programs such as Narcotics Anonymous or Alcoholics Anonymous are effective. In fact, from what I’ve seen, Alcoholics Anonymous is actually far more effective and beneficial than expensive treatment programs.

I realize that desperate family members who drain their life savings to send their loved ones to treatment for their addictions are doing it because the person they love will not go to meetings, do the work and endure the suffering required to heal from their addiction. They are losing someone they love and they are willing to do anything — including destroy themselves financially — to save them.

I have felt the same desperation and grieved the same grief over someone I love who is caught in the living death of addiction.

However, I speak from experience with the tragedy of addiction when I say that it’s up to the addicted person to want to change. If they ever reach the point that they are motivated to get help because they want to change for themselves, then AA or AN will do a fine job of helping them heal. Otherwise, bankrupting yourself will not help them.

By the same token, forcing insurance companies to open their coffers to pay for these outrageously expensive drug treatment programs will not help people who do not want to change, either. Statements that this will not raise the cost of health care are nonsense. These programs are massively expensive.

Since health insurance is now on the government dole, it will almost certainly end up contributing to our burgeoning national debt.

I wish there was a magic cure for these problems, but there isn’t.

From the New York Times:

WASHINGTON — The Obama administration on Friday will complete a generation-long effort to require insurers to cover care for mental health and addiction just like physical illnesses when it issues long-awaited regulations defining parity in benefits and treatment.

The rules, which will apply to almost all forms of insurance, will have far-reaching consequences for many Americans. In the White House, the regulations are also seen as critical to President Obama’s program for curbing gun violence by addressing an issue on which there is bipartisan agreement: Making treatment more available to those with mental illness could reduce killings, including mass murders.

In issuing the regulations, senior officials said, the administration will have acted on all 23 executive actions that the president and Vice President Joseph R. Biden Jr. announced early this year to reduce gun crimes after the Newtown, Conn., school massacre. In planning those actions, the administration anticipated that gun control legislation would fail in Congress as pressure from the gun lobby proved longer-lasting than the national trauma over the killings of first graders and their caretakers last Dec. 14.

“We feel actually like we’ve made a lot of progress on mental health as a result in this year, and this is kind of the big one,” said a senior administration official, one of several who described the outlines of the regulations that Kathleen Sebelius, the secretary of health and human services, will announce at a mental health conference on Friday in Atlanta with the former first lady Rosalynn Carter.

  • AnneG

    You are exactly right, Rebecca. The drug rehab industry has wanted insurance coverage since I used to work in mental health in the ’70′s. Your description is what I experienced and what continues to go on. There were heroine addicts, some well-known and well to do, who came in just to reduce their habits. No inclination to change. Actually deranged, psychotic patients were very difficult. They could be controlled with drugs, but went out of control very easily. Therapy was beginning to go out of favor and they could not be compelled to stay on anti-psychotic drugs. It is criminal how they are allowed to be a danger to themselves and others.
    AA has been very effective with alcoholics, but a lot of people don’t want to do the hard work. For some drug addicts small, local, faith based centers usually provide more hope than anything and these will be damaged or destroyed by government interference. Why do we think government can do everything? Socialism is very expensive and tries to replace God.

  • Bill S

    I understand that Obama wants to establish minimum standards for insurance policies. But I actually agreed with the Republican Senator when she said that not everyone wants to drive a Ferrari, some are satisfied with a Ford. People should have a right to opt for insurance policies with high deductibles and low upper limits and that might not get renewed if they get sick. Someone who cares about these people might want better for them, but they shouldn’t be able to force them to buy better policies even if they would be better off in the long run with better policies.

    It’s a tough one. On the one hand, Obama wants everyone to have good health care coverage. On the other hand, it shouldn’t be his call. He’s the President, not our mother.

  • FW Ken


    Everything you say is true; I’ve seen it in my own life and in the lives of friends. But it’s hard to not see mental illness as a key issue in this problem. I remember watching TV in 1966 when they broke in about Charles Whitman shooting from the U.T. tower. He was mentally ill. The fellow who shot up the youth rally at Wedgewood Baptist Church here in Fort Worth was schizophrenic . In fact, you can look at most of these mass shootings and see a mentally ill person. Some were ideological, but most not.

    As to addictions, I looked at my caseload of about 80 one time and found that drugs or alcohol were behind all but one case. Most were addicts committing crimes to get drugs, some committed crimes under the influence, most were selling, usually to support their own habit. I’m not naive as to the complexities – and failures – of drug treatment and recovery. But it’s a key element in reducing crime. According to this article, drug treatment yields financial, as well as personal benefits:

    According to several conservative estimates, every dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.

  • SisterCynthia

    It is really depressing watching addicts, and you are right, unless they WANT to change and work thru whatever has prompted them to take it up in the first place, and choose day after day to remain clean/sober no matter how badly they want their fix, no program is effective. Doesn’t matter if it’s in-patient, out-patient or AA/NA. I watched an otherwise nice person cycle in/out of jail and treatment for over two years on one job, and it was depressing watching them get clean (court mandated!) for a few months, then begin “cheating,” while in AA, with the episodes coming closer and closer together until they would have a violent episode and end up back in the county lockup. It is not a problem you can just throw money at and fix. It may make some politicians feel better, but it won’t bring the abuse rates down, any more than a bandaid on the wound of a patient gone septic will heal them of the infection.

  • Garrick D. Conner

    Rebecca, as a pastor and licensed mental health professional myself, I completely agree with your concerns. Even the most privileged of people must sincerely WANT change and WORK toward that end in order to experience it. I’m afraid that this new ‘mental health’ coverage will do little to help the vast majority of addicts. It also carries real potential to overwhelm an already stressed field of counselors and clinicians. I always appreciate your thoughtful and common-sense posts.

    • hamiltonr

      Thank you Dr Conner.

  • Manny

    You make a good case for addicts, but mental health is more than that. There has to be some coverage for people with real mental health issues. I don’t know what to do about addicts. That’s why legalizing drugs would be such a terrible idea.