Normative Narratives


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Transparency Report: The ACA, Mental Healthcare, and Mass Shootings

Despite reassurances by President Obama that “if you like your health insurance, you will not have to change it”, many people have been receiving letters notifying them that their current plans are being discontinued and they will be required to buy new ones. Perhaps Obama should have clarified his statement as follows; “if you like your health insurance, and it meets certain minimum requirements, you will be able to keep it.”

Why might a health insurance plan fail to meet these minimum standards? There are 10 “essential health benefits” that new policies must satisfy. The following analysis focuses on one essential service, mental health coverage, and its relationship to mass shootings:

The Obama administration issued a final rule on Wednesday defining “essential health benefits” that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.

Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.

White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.

Can we ever fully prevent mass shootings? No, there are elements of human will, technology, and finite security resources that make complete prevention impossible. However, there are steps that can be taken to drastically reduce the prevalence of such atrocities. One preventative measure would be to impose stricter gun control laws, which brings about the usual pro and con arguments. Less contentious ideas involve broader background checks (91% support) and increased government spending on youth mental healthcare (82% support).

One would be hard pressed to find an example of a mass-shooter who did not suffer from a mental illness. In fact, 48% of Americans think “failure of the mental health system to identify individuals who are dangers to others” shoulders a “great deal” of the blame for mass shootings (80% of people think this factor deserves a “great deal” or a “fair amount” of the blame). This is the number one factor Americans blame for mass shootings.

We often hear people say things such as “children are our most precious resource” or “I would give anything to protect my child”. The question I pose to my audience, and hopefully to the American public, is this. Do we want to be a country that makes a big deal about tragedies, a country that makes grand statements and then lets those statements fall to the wayside once the story isn’t recent news? Or do we want to be the country that puts its money where its mouth is, and actually implements the reforms we overwhelmingly believe in? One things is certain, mass shootings cannot be reduced by concentrated short term efforts directly after the fact followed by long periods of inaction.

True the survey says “increased government spending on mental healthcare”; however a great deal of people in the individual / uninsured market will receive free or subsidized healthcare, which is the equivalent of greater government spending on mental healthcare. Can we, as a nation, recognize this impact of expanded mental healthcare (not to mention the multitude of socioeconomic benefits associated with expanding healthcare coverage)? Are we truly willing to do anything to keep our children safe, or are we unwilling to even make the most basic investments to achieve this goal?

Update: Legislation is being finalized requiring equal coverage of mental healthcare by all health insurance. This is an important step in American healthcare reform, with untold socioeconomic and security benefits.

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