According to the National Institute of Mental Health, in the year 2015, about 43.4 million adults in the United States suffer from some sort of mental illness or disorder. That is 17.
9% out of the 326 million that call this country home. Serious mental disorders reported affected approximately 9.8 million, which is about 4% of all US adults (Serious Mental Illness (SMI) Among U.S.
Adults). This does not sound terribly significant till considering it is the equivalent of approximately 1 out of every 5 people. The number of people suffering from mental illness rises every day and will not desist without the initiative of society and the government. There is a multitude of laws and regulation in medical fields, mental health included, that attempt to cover every possible scenario that could arise. Two of these bills, HR 2646 and S 2680, will be discussed and analyzed in the paper. A breakdown and excerpts of both bills will be given throughout as well as an inspection of the after effects of these bills. Prior to delving into the individual bills, this paper will explain the path bills travel in order to be enacted into law, as well as other laws that have provided an influence into the mental health field. Providing a base of understanding for this process will give an additional layer of insight into these bills.
Showing some of the other laws that impact the mental health community helps to give a broader scope into the status of the mental health care system. In order for a bill to be passes into law it must go through an intricate process, bouncing back and forth between the two chambers, Senate and House. One chamber presents a bill internally, for an example coming from the House.
The members of the House will vote to either pass or deny a bill. If a bill is denied it can be revised and presented again. When the contents of a bill are agreed upon throughout the initiating chamber it is passed over to the Senate.
The Senate votes or suggests revisions. Back and forth the bill can be passed until either it is passed into law or dropped. After the revised bill is passed, if it is passed, it goes to the governor. The governor has the right to veto a bill or complete the process by passing it into law. All of these laws work together to better the national health care system by improving stability, boosting integrity amongst professionals, increasing help and access to those who cannot afford it, and restricting the slack of coverage created by lackadaisical practices. This interdependency of laws creates a structural foundation that new laws can constantly build upon and reform preexisting components to this foundation.
The initial law to be discussed is the Expanded and Improved Medicare for All Act (HR 676). This law is currently in the process of reformation and approval as of January 24 2017. It “establishes the Medicare for All Program to provide all individuals residing in the United States and US territories with free health care” (HR 676, 2016). This law is orientated to better create a maneuverable and beneficial health care system to those who cannot afford it. The participation with HR 676 is regarding only public and nonprofit institutions so the financial incentives that are offered to health care providers who make use of this law are restricted away from private sectors trying to only turn a profit. HR 676 also positions restrictions on health insurance providers. This bill does not allow a health insurer to sell health insurance that is the same as the benefits of this act.
Meaning, health insurance companies may not duplicate benefits set forth in this bill. On top of that, the Health Maintenance Organization (HMO) health insurance companies cannot offer further financial incentives to physicians based on utilization. Additionally, it provides a government-supported system to provide to the healthcare providers. Establishing The Medicare for All Trust Fund to finance the program with amounts deposited from existing sources of government revenues for health care, an increase in personal income taxes on the top five percent of income earners, by instituting a progressive excise tax on payroll and self-employed income, and by a tax on stock and bond transactions. It transfers and appropriates to carry out this act amounts that would have been appropriated for federal public health care programs including Medicare, Medicaid, and the Children’s Health Insurance Program (HR 676, 2016). These additional funds as shown will be pulled from additional taxing and established sources of revenue. Another law is the Building a Healthcare Workforce for the Future Act (HR 1006). This bill is an example of a possible effective law that could have improved the health career field.
It was initially introduced in February of 2015 but after being referred to the subcommittee of health it was dropped. It was reintroduced later that year under the title S 2107 and again was referred to the committee of health. HR 1006 was an attempt to help incoming and current medical field college students by granting an opportunity to reduce the cost of schooling.
This would, in turn, stipulate expectantly a spike in new medical professionals into the field. HR 1006 requires the Department of Health and Human Services to give grants to scholarship programs to make sure there is a reasonable amount of health professionals. Additionally, it directs the Institute of Medicine to study the documentation requirements for cognitive services (evaluation and management services) required under Medicare and Medicaid and through private health insurers (HR 1006, 2016). HR 1006 would assist to better prepare incoming health professionals to increase the quality of care provided by the national health care system. All of the bills that have been or will be enacted into law provide additional stability to the United States health care system. The purpose of these bills is to create improvements that help spread the coverage to ensure everyone who needs health care is receiving help. Increasing this coverage will assist to reduce the lack of provision to people who suffer from mental health ailments. HR 2646 is a bill that was initiated by the House also named the Helping Families in Mental Health Crisis Act of 2016.
The bill was voted for on June 6, 2016, and passed in the House and circulated over to the Committee of Energy and Commerce for revising. It was then amended on July 6, 2016, and approved. It was then passed back to the Senate for re-approval. HR 2646 is broken up into 8 titles, each of which is comprised of 56 sections collectively. Title I provides the layout for the renaming of the Administrator of the Substance Use and Mental Health Services Administration to Assistant Secretary for Mental Health and Substance Abuse along with revisions of the duties this position is responsible for including the review of programs regarding mental health and substance abuse. Title II declares that current law allows a state Medicaid plan to pay for primary care services and a mental health service furnished to an individual on the same day by providers at the same facility.
It also tightens down on Centers for Medicaid and Medicare Services in reporting coverage of services provided, opportunities to design innovative service delivery systems and collecting and reporting specified information. Title III establishes the Interdepartmental Serious Mental Illness Coordinating Committee to report on research, evaluate the effect of federal programs, provide a plan to improve outcomes for individuals and recommend agency actions to the better coordinate administration of mental health services. Title V is designed to create more accessibility to treatment for serious mental illness as well as setting a pilot program for assisted outpatient treatment. Title VI sets monetary requirements for grants towards evidence-based programs.
These requirements are in place to prevent the decline of beneficial programs and to promote progression. Title VIII is in place to increase mental health equivalence. S 2680 was sponsored by Sen. Lamar Alexander on March 15, 2016, with the title name Mental Health Reform Act of 2016. The goal of this bill was to create a more comprehensive mental health care system, which worked more efficiently and effectively. It was read twice in the Senate post introduction and then referred to the Committee on Health, Education, Labor, and Pensions.
On March 16, 2016, it was reported with an amendment of revision. The process was then delayed until action was taken again on the bill with more amendments on April 26, 2016. The same day it was placed on the Senate Legislative Calendar under General Orders. It has still yet to be enacted but remains an active bill. This bill amends the Public Health Service Act in a revision of the Substance Abuse and Mental Health Services Administration (SAMHSA).
It also creates a new position of Chief Medical Officer with SAMHSA. The Department of Health and Human Services is required to form a committee to evaluate the advancement of serious mental illness research, the effectiveness of Federal health programs, and suggested actions guided to improve upon the current mental health care system. This committee will be named the Interdepartmental Serious Mental Illness Coordinating Committee.They will be required to meet at least twice annually. The committee would be comprised of 9 government divisional heads in addition to no less than 14 non-Federal public members which would be appointed by Health and Human Services. This bill extends grants to community mental health services to help to ease the interruption of provision.
S 2680 also requires the Health and Human Services to ensure the access for health care providers of protected health information of people seeking or undergoing mental health treatment and substance abuse treatment. The access will help to eliminate any barriers between research and possible collaboration to reach a more suitable resolve for a specific mental illness. Allowing the communication between medical professionals and patients provides a more fluid process for diagnosis and treatment. There is a common goal which is prevalent in HR 2646 and S 2680, improve the fluidity of the mental healthcare system and provide increased efficiency and effectiveness to ensure spread coverage to the highest potential. Every plan has flaws and every system has weakness or blindspots, but these bills will work towards reducing or eliminating some of these hinderances. By creating these additional committees and positions such as, the Administrator of the Substance Use and Mental Health Services Administration to Assistant Secretary for Mental Health and Substance Abuse from HR 2646 or the Interdepartmental Serious Mental Illness Coordinating Committee of S 2680, will increase the level of productivity into researching and applying mental health care as well as increasing accountability for the correct processes and expenditure of resources. Setting forth strategic plans and accountable councils will benefit not only the well-being of the mental healthcare system but also the recipients of the health care provided. All of which will provide the next step needed to even better improve the current systems.
These actions can help to ease the number of people suffering from mental disorders and substance abuse disorders by providing adequate health care to prevent and cure certain mental disorders. Additionally, it will help departments to communicate and increase productivity towards the advancement of medical treatment for mental illness and possibly provide a framework to be applied to other medical fields to achieve the similar goals. As stated in the beginning of this paper, 43.4 million people suffer from some form of mental disorder (Serious Mental Illness (SMI) Among U.S. Adults). But the mental disorder is not limited to the major well-known disorders such as Schizophrenia, Dementia, and Personality Disorders.
It includes all mental disorders like depression, substance abuse, and anxiety disorders, just to name a few. Anxiety disorders are among the most common mental disorders in America, but they are predominately highly treatable. Regardless, according to the Anxiety and Depression Association of America, 40 million people are affected by anxiety disorders but only 36.9% of those are receiving treatment (Anxiety and Depression Association of America, 2017). These disorders have the capability to impair daily life and productivity to society, hindering the life quality of the people suffering without treatment. In conclusion, there are a plethora of laws and regulations that help to better the mental health care system.
But there is always room for improvement, which the two bills HR 2646 and S 2680 would provide. Everything in the world has some sort of foundation, whether it be physical or non-palpable. These bills provide for the improvement of the foundation for the mental health care system. Establishing these additional adjustments, regulations, and committees will improve stability, functionality, effectiveness, and accessibility of the mental healthcare system. The capability to reduce the number of those suffering from mental illness is there, it is just a matter of harnessing the potential the healthcare system holds.
It is improbable to have every single person with a mental illness receiving treatment, but for those who seek treatment should have access to it, regardless of financial or environmental blockades. HR 2646 and S 2680 will be the next step in the right direction of mental health reform and provide the additional accessibility and productivity of the mental healthcare system. There are 43.4 million people suffering from mental illnesses, this help takes the next step towards the best possible healthcare system.