The US has been described as one of the most expensive countries in terms of healthcare costs. Every year that passes it seems that the primary intention is for medical providers and health institutions to continue growing their profits rather than offering a quality and affordable healthcare (Mason, Gardner, Outlaw, & O'Grady, 2016). In many cases, the health insurance companies are at fault where they offer different care plans depending on the nature of illness an individual suffers from. The more likely a patient is to receive medical attention, the higher the insurance premiums (Mason et al., 2016). The severity of the disease seems to dictate the cost an individual will incur in medical expenses. The practice is unfortunate particularly for mental health patients (Mason et al., 2016). While an individual is suffering severely because of a particular disease it should not be the reason to highly inflate the cost they should incur when receiving medication or medical attention from relative practitioners.
The basic concern in the healthcare industry is that majority of insurance plans do not usually offer parity for mental health conditions when compared to other chronic illnesses (Mason et al., 2016). This policy was developed as a measure of ensuring equal treatment of mental health issues and substance abuse disorders with other medical conditions. In this regard, if an insurance plan offers unlimited visits to a physician for chronic condition like coronary heart disease then it must also offer unlimited visits for depression or other mental disorders (Mason et al., 2016). The issue of parity does not mean that the insurance plans will offer better premium charges In comprehensive coverage, it only requires the insurance providers to offer equal coverage not “good” coverage. In cases where the insurance plan is limited, it is likely that the coverage on mental and substance abuse disorders will receive similarly limited coverage even in state that have strong parity laws (Mason et al., 2016).
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How do you see health policy impacting nursing practice in that arena?
It is evident that while numerous states have implemented and enforced the law on mental health parity, there are many patients who continue to suffer due to limitations in their insurance plans. It is evident that the nursing practice is heavily impacted by the health policy (Corrigan, Druss, & Perlick, 2014). In their capacity as health educators to the members of the community, nursing practitioners should help clients identify the various health plans that must follow federal parity plans. The number of insurance plans that should adhere to this practice are many and the patients or their families can choose one that suits their financial capability and health needs (Corrigan, Druss, & Perlick, 2014). Some of the plans include State Children’s Health Insurance Programs, Medicaid Managed Care Plans, group health plans for employers with 51 or more workers, and the Federal Employees Health Benefits Program among others. Nursing practitioners should also advice the clients they interact with on the insurance plans that do not have to follow federal parity law (Corrigan, Druss, & Perlick, 2014). This approach will help individuals change or take an additional insurance cover.
The mental health parity law influences nursing practice as nursing practitioners are expected to provide clients with information on the benefits that comes with the plans. In this case, individuals who are on insurance coverage that must abide by the federal parity may enjoy numerous benefits associated with treatment limits and payment amounts (Corrigan, Druss, & Perlick, 2014). It is evident that the law enables equal coverage similar to those of chronic illnesses. Some of the services include emergency care, outpatient and inpatient in-network and out-of-network, residential treatment, co-pays, partial hospitalization, maximum out-of-pocket limits, prescription drugs, and facility type among other benefits (Corrigan, Druss, & Perlick, 2014). It is also important for nursing practitioners to educate their patients on ways they can identify whether their healthcare plans are violating parity requirements.
References
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15 (2), 37-70.
Mason, D.J., Gardner, D.B., Outlaw, F.H., & O'Grady, E.T. (2016) Policy & Politics in Nursing and Health Care,7th Edition . St. Louis, MO: Elsevier Inc.
