Costs and Coverage

Falling numbers of insured is bad news for psychology.

By Colin Allen, published on October 01, 2002

Last year, 1.4 million Americans suddenly found themselves stripped of health insurance, according to the latest figures released on September 29. The Census Bureau reports that after two years of decline, the number of uninsured has risen to a whopping total of 41.2 million due to increased premiums and a weak economy. This is all bad news to the mental health field, where relations with insurance companies have never been strong.

"Mental health has always been an ugly stepchild for insurance companies," explains Steven Tovian, Ph.D., director of health psychology at Evanston Hospital in Highland Park, Illinois. "They are afraid that [therapy] gets abused. It's the proverbial Woody Allen syndrome: He's in treatment for life." Tovian notes that this false stereotype of mental illness as incurable affliction leads to discriminatory choices by insurance providers.

"They're in a bind if they are paying for it," notes Trovian. Reporting a diagnosis and subsequent treatment may not be enough to warrant coverage from a company's point of view. And further investigation into the cost-effectiveness of therapy often violates client-patient privilege, leaving insurance companies without a reliable method for monitoring the success of their investment.

Certainly, an increase in the number of uninsured will negatively impact the entire health care industry, but psychologists may feel a more acute sting. "I've seen schizophrenia, and I've seen cancer," says Trovian. "They are equal opportunity devastators."