Insurers skimp on eating disorders
TEXT OF STORY
Doug Krizner: The cost healthcare is an ever-increasing challenge, especially for folks with eating disorders. Conservative estimates put their number at nine million in the U.S., and many of them and their families face real financial hardship. Rachel Dornhelm reports.
Rachel Dornhelm: Sitting in her kitchen in Lafayette, CA, Anne ticks off the only six foods her daughter ate when her anorexia was at its worst.
Anne: Diet soda, cantaloupe, egg substitute, salsa, celery and sugar-free jello. And even if you double the calories I was observing that’s only 300 calories a day, which is obviously not life sustainable.
This was after her daughter met many times with a nutritionist, a psychologist and a medical doctor.
Anne, who asked that only her first name be used in this story to avoid problems for her daughter, says when her 19-year-old child began having heart trouble, their insurance company said it would only pay for a brief hospital visit.
Anne: We were very fortunate that we have equity in our home, but we had to take out an equity loan, $33,600. It turned out our daughter needed a five-week stay.
James Lock, a professor of psychiatry at Stanford, specializes in eating disorders. He says many families are forced to use money in retirement and college funds to cover residential treatment programs for anorexics and bulimics.
These are one to two months and can cost $80,000. That’s a big expense for a life or death disease, that’s little studied. Lock says most insurers demand proof of efficacy.
James Lock: That is a reasonable argument on the one hand, and on the other hand this is what we know and the best we can do for now. With every treatment that we do we try and understand if it’s going to be cost effective or not.
There are people who get their stay in a residential program covered. Sam Menaged is the CEO and founder of the country’s first eating disorder facility, the Renfrew Center. He says he created a unit to work with managed care companies and now most of his clients get covered. But Menaged says health insurers must work to set realistic care standards.
Sam Menaged: Eating disorders are much more complex than most other psychiatric disorders which can be treated with medication.
That’s why he backs the Mental Health Parity Law now before Congress. It would require health insurers give equal benefits for mental and physical illness.
Meanwhile Anne got reimbursed and paid back her equity loan — only after she hired a consumer advocate.
I’m Rachel Dornhelm for Marketplace.
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