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Eve Luppert commented on Talk therapy about mental health parity on October 14, 2009, 9:16 PM

PS, it's true about not being invited back.

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Talk therapy about mental health parity

Whenever people become delighted that we might finally legislate mental health parity (mental health care is treated as any other illness without a cap on dollars or number of visits per year) I find myself twitching just a little bit, and licking the bottom of the valium bottle.  That's because mental health parity is another great example of insurance companies playing at helping the consumer find cost savings and supporting health maintenance but not delivering. When I was negotiating health care benefits for my company the benefit directors in my town were invited to an annual lunch where we were to learn about what's next in insurance.  The event, sponsored by Blue Cross/Blue Shield in my state, was a day of coffee, conversation with others in our field and maybe to meet the "greats" of BCBS who cared about us so much they took the time to attend our little luncheon. We would be treated to a series of lectures about why all our premiums were going to go through the roof at renewal, and why it was really all our employees fault.   Since the theme for the past few years had been our premiums were going up because our rotten staff was insisting on taking the medications their doctors prescribed, this year they were looking for a fresh approach. Since so many more people were already using generics and our costs still weren't going down, it was time for a new group of employees to blame.  And who better than the frazzled, exhausted and stressed-out to make the bad guys. During the course of the day they spent a lot of time talking about how stress leads to more serious illnesses. This made sense to us because we in HR were the ones everyone was going to hate when we stood up and told the employees how much more they were going to pay for the same care. No one had to convince the "our lady of the peptic ulcers and HR" gracing the big round tables that stress was a killer. They even had an actuary come up and give us a bunch of numbers on a spread sheet showing just how much stress related illnesses became more serious illnesses.  it was very impressive.  And those of us who were wrecks ourselves, but never had seen a shrink got to feel all righteous. Sort of like we were willing to loose our minds for the good of the company. I asked the speaker after about an hour of this, why, if BCBS understands that mental health effects physical health, they don't offer mental health parity in their plan. The guys tells me, believing I'll be pleased, that in fact the issue was in front of the NC state legislature right then. (Of course, he didn't point out that they were lobbying against it). I then said that to my knowledge there was absolutely no law preventing them from offering parity without the legislature's interference. He uncomfortably agreed. So I asked again, "if you tell me that there are huge cost savings for you and your customers if we have access to mental health, if for no other reason than to reduce stress ,why doesn't BCBS do cover it?"   He was unable to answer me. The truth is the sicker we get, the more they raise our premiums. BCBS of NC made 800 million in profits in Q1 of that year...and they are a not for profit company! But they still tried to raise our premiums 20% this year and we had a pretty uneventful year health wise. They "blame the victims". They tell us it's our fault for taking medications that help us get better, while they lobby with big pharma for the legislature to extend the patents on drugs keeping them off the generic list for longer. They blame people for being fat, but they don't cover gym memberships, let alone that stress is a big cause for obesity. And while I believe in wellness programs because they are a good thing for a company to do for their employees, they don't, as far as I have ever seen, come back to reduced premiums. I worry too that many citizens have sipped at the "it's people's fault" fountain and are now becoming intolerant with each other, rather than understanding where the problem is.   The words "mental health parity" tend to be a trigger for me.   So why do I twitch?  Well, after asking a series of what struck me as obvious questions through out the day, not only did they refuse to call on me when I raised my hand, I wasn't invited back the following year.  Instead they invited one of my junior  staff from another office hoping I wouldn't find out. I don't deal well with rejection. I wish I could afford a therapist, but I've hit my annual max! … Read More

October 14, 2009   |  In Health & Medicine

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Sports analogies at work, or What are you talking about?

How many times have you been in a meeting when some manager says, “We are at the bottom of the ninth, people, and the goalies need to step in and shoot a birdie before the clock hits the two minute mark or our third baseman will foul out. People, what we need here is a touchdown.” If  this makes no sense to you, believe me it makes even less sense to me. It also makes no sense to thousands of women and quite a few men in the work place either. But sports analogies are a favorite among so many managers I know. Of course, I’ve learned to smile and nod knowingly when the president of the company tries to cheer us on with references to line drives or putting a spin on the ball. I have learned that a touchdown is a good thing and we want one. Still, while benign, these analogies are alienating to a lot of people in the meeting. It is like being Charlie Brown; sitting at his desk while the teacher goes “wha wha wha”. It matters because lots of people in the audience have a feeling that the speaker isn’t really talking to them. It matters because too many times in my career as an HR manager I’ve seen great women passed over for promotion because their managers don’t “get her”. Truly those very words were the explanation given to me when the two men were promoted over a woman who made more money for the company, worked twice as hard and had a team that would follow her to the end of the earth. So several years ago, just to make a point, I began to reply to sports analogies with cooking, sewing or fashion analogies. Now, I am only a passable cook, and I can’t sew at all, but even if I didn’t know what I was talking about, I could bet that the prior speaker didn’t know any better. After a long diatribe ending with “base hit” I now make it my business to say, “I know! This is sewing on the bias, people, and the hem stitch is just about to hit the dart.” Then I smile at everyone, with a who-hasn’t-been-there look. It doesn’t make sense sure, but it gets the point across. Here are a few suggestions for those of you who are being “coached” to succeed in a game you know nothing about. “What we are really talking about is wearing Jimmy Choo shoes with a Hermes bag.” “We are on the verge of having the egg whites curdle” “It’s like being under the dryer, folks. Get out too soon and the highlights won’t show, get out to late and it’s frizzies for our split ends”“Look, we have to decide, do we want the curtains to swag or drape?” “What we have here is a kitchen full of souse-chefs when we need an saucier.” "If you can't knit, purl.  If you can't purl, then cast off." Do it in good humor. It’s more effective than making a stink about it. Have fun with it. I do.   … Read More

September 18, 2009   |  In Business & Economics

Work: The insurance entitlement program

The question so many of us fail to ask is why do we believe that access to health insurance is an entitlement of working people only? (And those who can work at a company that offers health insurance only, while we are at it) Or in other words, how did we get health care and employment to be so mixed together? When you think about it one really doesn't have anything to do with the other except by pretty recent custom. Offering health insurance started out as a perk to attract people. It never was intended to be the only real affordable choice. But over time, that is what happened. The costs shouldered by industry have become a huge burden. (GM who had to be bailed out was talking about this burden a year ago). The cost to the employed and unemployed are now impossible. And instead of government bureaucrats getting between us and our doctors we have company bureaucrats with a profit motive with more accountability to share holders than their customers getting between our doctors and our health. It is time for a real change. The vast majority of Americans no longer buy the "George and Martha" spin sent out with the Clinton Administration tried to make this change. Too many have lost jobs and affordable coverage along with it, or are paying outrageous costs, even with supplements from their employer. … Read More

July 12, 2009   |  In Health & Medicine

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Eve Luppert commented on How a single-payer health care system can drive innovation into the economy on June 18, 2009, 11:25 PM

>>At the same time we want to feel like we are not paying for others bad health habits. This could be solved by creating mutual funds or bond accounts.<< But that is how all insurance works.  If you are healthy now, you are supporting those that aren't healthy now....and later, when you aren't healthy, the healthy take care of you. Since most health insurance companies are taking in huge profits, the idea that your rates are insane because Joe and his family down the street always eat at MacDonalds and smoke is pretty insincere.  Costs go up because of greed.  And because the insurance company increase their profits by denying coverages that your doctor recommends, and then blame you and your doctor for needing the care.  It's blaming the victim. There has been a movement that is somewhat like your mutual fund idea..it is called health care savings accounts.  Many companies have been offering this as a way to reduce costs...and I'll say it does.  You pay a premium to the insurance company, but if you need any care you take the contributions you have made (not counting premiums of course) and any your company may make on your behalf and then use that money to pay for care.  They've finally figured out how to take you premiums and not pay anything out....genius. The truth is a tiny little portion of the insured use the doctors office as a time waster.  This is not the problem The premise is that costs are high because you and I love going to the doctor for the heck of it, have procedures just because we can and take prescription we don't need.  Clearly they are doing a good job of convincing their customers that while you need your medicine, no one else does.  Further, they think that if we are consumers we will shop around for better prices.  So, when your daughter breaks her arm, rather than rush to the nearest emergency room, you'll get on the phone and price shop.  Or when you are prescribed something for your acid reflux, you'll price shop (which of course is a waste, since all prices are the same) or settle for Tums and milk, until your esophogas rusts, and then you'll call around for a cheap surgery.  So, the insurance co's have been very successful with much of the population (and too many of our elected officials) at convincing us the problem is us...well, not us, but all those other lazy, bad habit attention seekers that are on your plan.  But, look at the profits these "non-profits" make and your head will spin. 

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