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Love it or hate it, Medicare has become one of the major pathways to healthcare in America.
With all the hassles of health insurance, either private or employer-provided, government-mandated healthcare is becoming more and more popular.
After all, you won’t go bankrupt by calling an ambulance if your healthcare providers accept Medicare.
But for the longest time, Medicare only extended as far as physical ailments. However, these are tough times not only on the body but also on the mind. And the conversation on mental healthcare, specifically affordable mental healthcare, has only become louder.
So, the question everyone had for a while was whether a public healthcare system could help with that. Is there a way we could guarantee accessibility to mental healthcare providers such as therapists and counselors for some of the more vulnerable groups in the country, such as the elderly?
It turns out that Medicare only recently updated its coverage, and mental health was on the list. But what does that entail exactly?
- The rise of mental health issues in the past decade
- Medicare and Mental Health Coverage in America
- How affordable are Medicare’s mental health services?
Mental Health: A History Lesson
Despite what people like to believe, mental health isn’t just a buzzword that suddenly appeared out of thin air.
The concept of community-based ‘mental hygiene’ was conceptualized by Dr J.B. Gray, right after the Civil War. He envisioned a management plan for a healthy mind based on factors such as education, social awareness, and even religion, which was pretty forward-thinking for the 1800s.
This idea of mental hygiene was later given a more concrete definition in 1893. According to the founder of the American Psychiatry Association, Isaac Ray, mental hygiene meant preserving the mind against any trauma that could reduce its functioning capabilities or impair it in any other way.
By the 1900s, we were well into the swing of seeing mental health as more than just a malady of the mind, but also a response to the hectic industrialization and exploitation that the era brought with it. Adolph Meyer was the biggest proponent of this, with his experience working in mental institutes convincing him that fast-paced urbanization was detrimental to human potential.
And this was more than a century ago. Sure, that was the era of shock treatments and casual lobotomies, but some forward thinkers were slowly realizing that the mind needs care and maintenance just like the rest of the body. The idea was that humanity couldn’t keep going on while suppressing their mental health needs.
Dr. Paul Lemkau was one such individual. He expanded on the work of his predecessor, Meyer, and following the National Mental Health Act of 1946, he went on to establish the first National Institute of Mental Health.
Dr. Lemkau was always passionate about psychiatry and the mental well-being of his community. He actively advocated for issues such as decentralized mental healthcare whilst actively training future professionals for the mental health crisis that had taken hold post-World War II.
And while our generation isn’t actively recovering from a World War and a Great Depression, mental health in America still is going through the wringer.
Medicare: Taking On Mental Health
Here’s the scoop: Mental health disorders are one of the top comorbidities of disabilities in the U.S., with over 60 million people experiencing mental health issues in the last couple of years alone.
This isn’t surprising, because that figure comes from 2021-2022. So, right after the 2020 Pandemic when people were shut in for months on end, leading to an economic downturn so severe, we still haven’t comprehended its full scope.
So, it’s a welcome relief that Medicare does cover both inpatient and outpatient mental healthcare services, such as hospital stays and therapy.
Medicare is a federal program designed for those 65 years and above, who are often one of the most overlooked demographics when it comes to mental health issues. But the way it works is that two plans are set up and govern different aspects of mental healthcare.
Medicare A takes care of inpatient facilities, such as getting admitted to a general or psychiatric hospital for treatment or rehabilitation. However, while general hospital stays can be indefinite, Medicare A only covers 190 days at a psychiatric facility.
Medicare B, on the other hand, is for outpatient facilities like diagnostic tests, screenings, and therapy services. Under Medicare, you are eligible for one Depression screening per year alongside single and group therapy sessions, and even some psychiatric evaluation tests and prescription drug follow-ups.
However, not all medications come under the Medicare umbrella.
A less talked about benefit of Medicare B is its partial hospitalization service, which is the middle ground between a weekly psyche visit and full admittance. It is an intensive daily program where you check in for a treatment plan that can span up to 20 hours of therapy per week.
Partial hospitalization is an alternative for those who can’t commit to inpatient services, but still need medical intervention for their mental health disorders.
It can be availed at a community mental health centre but Medicare would not be responsible for food and transport costs. And while support groups are out, you can still avail of group therapy sessions there.
Why Accessible Healthcare Has Been A Long Time Coming
As discussed before, America has a real mental health problem going on right now, with a rising trend in self-reported cases of general anxiety, depression, and panic disorders.
That has only been exasperated by the COVID-19 pandemic, to the point where the White House had to issue a report on just how bad the mental health crisis has gotten in the past 4 years. And sadly, many people still can’t access the help they need.
It is reported that at least 10% of all adults with a mental illness have no health insurance, leaving millions of people nationwide susceptible to a worsening mindset. What’s even worse is that even if people do have insurance, it doesn’t always end up covering mental health issues at all.
For all that our country is excelling in many of its sectors, healthcare remains one of the few where it feels like we’re only going backward. America ranked last when its healthcare measures were compared to other industrialized countries like it. Which is troubling when you consider we have the most expensive healthcare in the world.
So, making healthcare accessible should have always been on the agenda. But mental health has always eluded that conversation.
Some obstacles make mental healthcare much harder to access in the first place.
Alongside a physician shortage, we don’t have that many mental health specialists active in the country either. The official ratio is that for every 340 patients, there is one mental health provider, which is already an absurd figure.
But the problem is a lot of those mental health providers might not even be currently practicing, leading to an inflated number.
And without private health insurance, employer insurance, or even Medicare, some people can’t justify getting mental health help at all. Either the healthcare system processes their complaints too slowly, or sometimes the cost of therapy and medication is just not feasible.
The problem here is that affordable and accessible healthcare should be a given. People shouldn’t have to lose an arm and a leg or turn to drastic measures to receive the medical care they require. And universal healthcare such as Medicare is a step in the right direction for that.
Final Thoughts
Everyone deserves healthcare, I think we can all agree with that. Basic physical and mental facilities should be a right for everyone, even for those groups that are not actively productive, like children or retirees.
For that, Medicare is a step in the right direction because while it may not be perfect, it is a start.
