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Comment Catcher: Part 3 of Why You Can't Find A Therapist, No, Really siderea October 1 2016, 03:26:00 UTC
The comment catcher comment for catching comments.

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Re: Comment Catcher: Part 3 of Why You Can't Find A Therapist, No, Really nancylebov October 1 2016, 05:26:55 UTC
Possibly of interest: Two Cheers for Anarchism by James Scott-- it has a lot about informal organization.

It seems to me that this uncoordinated strike isn't about cooler or hotter heads, it's about insurance companies not paying enough money. The strike will end when insurance companies offer enough money for therapists to live on.

I hope this won't come off as too wiseass, but what are the economics of being a fortune teller? Part of what they can offer is rather like therapy. (Fortune telling is legal in Philadelphia, I don't know about elsewhere.)

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Re: Comment Catcher: Part 3 of Why You Can't Find A Therapist, No, Really siderea October 1 2016, 20:52:24 UTC
According to this, MA requires fortune-tellers to be licensed.

I.... wut.

Now I need to find out what it takes to become a licensed fortune-teller.

ETA: OMG [PDF]

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OMG nuclearpolymer October 1 2016, 23:45:56 UTC
Whoa...I had no idea.

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ext_3333921 October 1 2016, 06:47:45 UTC
What struck me as you reached your ultimate point is that for insurers, it isn't usually a problem if their customers can't find therapists. When consumers (or more to the point, employers) are shopping around for insurance, they just see "Ooh! Mental health coverage!", and generally don't investigate whether that coverage actually means a damn thing in their area. When it turns out that they (or their family) actually need some therapy, and they can't find anyone, that means the insurance company saved money! (Unless, of course, the patient subsequently needs an expensive hospitalization, which they might have avoided if they got some damn therapy in time.)

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siderea October 1 2016, 20:26:45 UTC
ExACTly.

I feel moved to share one of the most WTF insurance stories I have.

CommonwealthCare Aliance OneCare (== "CCA OneCare") is a newish (3 years old?) insurance thingy for people in Massachusetts who are jointly eligible for both Medicare and Medicaid.

I don't know whether CCA OneCare is an option those patients can elect (and if so, whether opt in or opt out) or whether they're assigned to it without recourse.

Anyways, I had two patients who got converted to CCA OneCare. The clinic I was working for then had a bunch.

CCA OneCare did this thing that is otherwise unprecedented in not just my experience, but in the experience of a bunch of other clinicians I've spoken to.

We submitted claims to them, which they approved and didn't pay for.

That is: we submitted the claims, they indicated to us that they had been approved, and then, just.... never got around to sending us a check.

Usually, of course, insurance companies that don't want to pay deny the claim. They say, "We're not going to pay this because of reasons". ( ... )

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ext_3333921 October 2 2016, 03:40:53 UTC
I am appalled, but I can't quite muster up surprise.

My impulse is to say that there ought to be some "truth in advertising" law, such that an insurer can't claim to cover a particular service if they can't get enough providers to accept them. So if they intend to cover psychiatry, but have no or almost-no psychiatrists in their network, they are not actually covering psychiatry and cannot advertise that as a benefit. Of course, I'm sure that would get all kinds of complicated and screwy in the implementation.

I await the day that we burn the whole health insurance system to the ground and raise something sensible from the ashes.

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qualmish October 2 2016, 21:34:44 UTC
Switzerland apparently did that without too big of a bonfire in, uh, I think the early 1990s. I would love to see that happen in the US. Appalling is absolutely correct.

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