UNITEDHEALTH: ‘Final Say’ Change Excludes Mental Health

      The Associated Press reports today that UnitedHealth Group's change in policy leaving final medical decisions to doctors has one notable exception -- mental health care providers. Fearing a potential rise in costs, the HMO will not allow mental health care providers to have the final say in deciding care. "Mental health holds a lot more intangibles than medical care in determining what treatment someone needs," according to Saul Friedman, CEO of United Behavioral Health, the company's subsidiary which manages mental health and substance abuse benefits for 17 million Americans.

'Poor Stepchild'
      Mental health providers and advocates are not pleased. "Mental health is always the poor stepchild, and this is more evidence of that," Russell Holstein, a Long Beach, NJ, psychologist, said. Karen Shore, president of the New York-based National Coalition of Mental Health Professionals and Consumers, was disappointed but not surprised. "There is a ... mean-spirited bias against mental health, which the people in charge do not understand," she said. Friedman counters that legitimate differences exist between mental and medical care and contends that managed care has put important controls on mental health care. "In the old days, everyone went to (psychiatric) hospitals forever and it drove up costs," he said, adding, "It's important to note that our decisions almost never relate to care or no care, but are related to the level of care." He added that new mental health parity laws passed in 27 states requiring equal coverage for mental and physical ailments will push up costs unless the company keeps tight control on care (AP/Washington Times, 11/12).