On the down side

Now that insurance is supposed to cover mental-health disorders to essentially the same extent as it does other ailments, Megan McArdle has some doubts about the whole thing:

I am very sympathetic to the plight of the mentally ill. Unfortunately, most of the people who will tap the benefits are not severely ill people who need intensive care; they’re people who are unhappy. Unhappiness is not a condition for which psychotherapy, or antidepressants, have been shown to be very effective. (Severe clinical depression, yes. But contrary to the belief of people who felt awfully down the time their boyfriend left them, these two conditions are not the same thing.) Since the moderately unhappy and dissatisfied are much more prevalent than those with serious disorders, that’s most of what we’ll be paying for: someone to listen to complaints. That’s what Senators are supposed to be for.

On a more serious note, I feel like we could have achieved the laudable goal of ensuring that serious mental illnesses are not left untreated (at least, in cases where the patient wants to get treatment), without guaranteeing cheaper psychotherapy for America’s ennui-laden affluent classes. Of course, then we’d have to recognize the fact that this stuff has to be paid for, rather than pretending that benefits can somehow be magically generated for free with just a wave of the regulatory pen.

Laden with ennui as I am, I’m not anywhere near affluent, and I struggle with something that is more than mere unhappiness but perhaps less than clinical depression. (I know from clinical depression: I had it through most of the 1980s. It broke up two households, including one with only one person living in it, and landed me in the Home for the Bewildered for a month and a half.)

Treatment for this particular inchoate ailment consists of one tranq and ¾ to one full sleeping tablet, daily. Estimated costs before insurance: $1,000 a year. This will buy — what, five, maybe six sessions on the couch with Dr Sturmunddrang?

And besides, since when do Senators listen to complaints?


  1. Francis W. Porretto »

    2 February 2010 · 3:41 am

    Laden with ennui as I am…

    We’re very sorry, Mr. Hill, but your policy only covers angst.

  2. Brian J. »

    2 February 2010 · 2:27 pm

    You know what makes me most angry and/or sad?

    When Republican congresspeople in Washington oppose the President’s health control policy and talk about removing mandatory coverages while Republican state legislators continue proposing them.

  3. Lisa Paul »

    2 February 2010 · 3:34 pm

    What gets me is any Congresspeople who oppose extending healthcare for us, but continue to enjoy their very generous, expansive Government run healthcare and coverage (including comprehensive dental) that they have for life. And which, I might add, WE pay for.

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