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Comment by brendanyounger | Hacker News Reader

While I have no love for Ambetter, I think we need to ask whether behavioral health services should ever be covered by insurance. From 10,000 feet, the behavioral health product is terrible. There's no clear timeline for how long it takes to get better, and it's nearly impossible to objectively compare provider quality using any publicly available data set. In short, it's a terrible match for insurance as a product. Which is why we're in this pickle.

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i take it you don’t have a lot of experience with the healthcare system prior to 2008 or so when parity for mental health benefits became a requirement. let me tell you what a hellscape it was. it was pretty well accepted practice to never use insurance for mental health, because if you tried, not only would your claim be denied but it would be a preexisting condition forever after that. if you had your GP prescribed an antidepressant —preexisting condition. if you did manage to find someone who took your insurance it was a six month wait for an appointment. and then (because it was pre obamacare) you were highly likely not to be able to get coverage again if you ever had to change insurance providers on the private market. people stayed at jobs years longer than they wanted to solely because of healthcare benefits like mental health.

basically, only those who could afford to pay out of pocket got access to mental health benefits.

i often hear people think out loud, we’re should just let the market dictate X, and it boils my blood because they clearly weren’t paying attention the LAST time we just let the market decide something like this, and it killed a lot of people.

> nearly impossible to objectively compare provider quality using any publicly available data set.

That's true for all medical specialties I know of in the US, except there are some useful published measures for hospitals and surgical centers.

> the behavioral health product is terrible

So it is, so are most specialties. But plenty of patients do get actually useful help with basolutely recognizable improvement. Often night and day.

So. Is it useful and needed? Yes.

I would think the highly variable costs make it a great fit. The whole point of insurance is to spread outlier risk across a large group of people.

(To be clear, I have no love for the health insurance industry in general, but it's for reasons other than this.)

Yes. the answer is yes we want mental health to be covered.

"We"? Who are "we" here? Isn't this decision completely in the hands of the insurers themselves?

Not really (ultimately, though, the nuclear answer is 'yes'). Many states, including mine, have mandated that for a health insurance carrier to do business/be licensed in our state, that certain minimums for mental healthcare must be met.

Insurance generally does cover chronic conditions where the patient only stays “better” as long as treatment continues.

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