Excerpt from Health Reform Watch: (click for entire article)
What group could health reform help most? The obvious choice (maybe the right one) would be people with no insurance, or lousy insurance. It is clear that un- or underinsurance is bad for your physical and fiscal health. How about people in need of skilled nursing care and assistance with activities of daily living? Some provisions of pending bills would allow these folks to avoid the Hobson’s choice of institutional care or too little care. But the cohort that might stand to gain the most from reform is the population of people with serious mental illness.
People with serious mental illness have long been known to have excess morbidity and mortality as compared to people without serious mental illness. Although much of this excess is attributable to “unnatural causes” - e.g., suicide – studies have identified in this population substantially elevated natural causes of illness and early death from conditions such as cardiovascular and respiratory disease. Some of these conditions are caused or exacerbated by side effects of newer atypical antipsychotics. Much of this excess morbidity and mortality is preventable, and some causes (e.g., poorly controlled diabetes) could be addressed through sound chronic care management techniques I’ve described in an earlier post. Inadequate attention to the management of the medical concerns of people with severe mental illness could be a particularly attractive goal of health delivery reform.
What group could health reform help most? The obvious choice (maybe the right one) would be people with no insurance, or lousy insurance. It is clear that un- or underinsurance is bad for your physical and fiscal health. How about people in need of skilled nursing care and assistance with activities of daily living? Some provisions of pending bills would allow these folks to avoid the Hobson’s choice of institutional care or too little care. But the cohort that might stand to gain the most from reform is the population of people with serious mental illness.
People with serious mental illness have long been known to have excess morbidity and mortality as compared to people without serious mental illness. Although much of this excess is attributable to “unnatural causes” - e.g., suicide – studies have identified in this population substantially elevated natural causes of illness and early death from conditions such as cardiovascular and respiratory disease. Some of these conditions are caused or exacerbated by side effects of newer atypical antipsychotics. Much of this excess morbidity and mortality is preventable, and some causes (e.g., poorly controlled diabetes) could be addressed through sound chronic care management techniques I’ve described in an earlier post. Inadequate attention to the management of the medical concerns of people with severe mental illness could be a particularly attractive goal of health delivery reform.
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