Question:
Why is it that good psychiatric treatment is so expensive, even with health insurance? It seems to me that we as a society are saying that mental health care is only for the well-to-do.

S.J.
Princeton, New Jersey

Answered by Alex Beam:
As I am sure you know, the issue of mental-health "parity," meaning equal treatment of mental and physical health by public and private insurers, is currently the subject of hot debate in the U.S. Senate and elsewhere. I am virtually certain that "parity" will not become a reality any time soon, but I am a great pessimist.

The 50-minute psychiatric "hour" is not particularly expensive, so presumably you are referring to the kind of residential therapy that, to be blunt, belongs to yesteryear. If you saw this documentary, John Nash was at McLean Hospital for 50 days, which was then deemed close to the minimum stay. Now, of course three to five days residential stays are considered good deals, and few insurance plans cover more than that.

And of course drugs are expensive. At the threshold level, Lilly was working very hard to create a "new" Prozac, so that "old" Prozac would not seem like a bargain when it went generic. Although that effort did not succeed, psychiatrists are under pressure to prescribe newer, presumably better -- and thus more expensive -- drugs.