To the long list of problems with the health care system in America that have not been solved by ObamaCare (or, for that matter, by RomneyCare) add what Mass. General Hospital in Boston calls the crisis in pediatric psychiatric emergency rooms:
the trouble starts with Billy's insurance. After about an hour on hold, as well as a detailed presentation from the doctor to the insurance company over the phone, the insurance company refuses to authorize the hospitalization. The company has a contract with three hospitals in the metropolitan area, and those hospitals' adolescent psychiatric beds are all taken. The law requires that Billy receive the minimal emergency treatment necessary for his health, but not necessarily anything more. Therefore, since Billy has not acted on his thoughts with the noose, the insurance company is unwilling to pay the huge out-of-pocket costs associated with hospitalizing Billy at an out-of-network hospital. They're not denying that he needs to be hospitalized; they stress over the phone that that particular decision is a medical one best made by the doctors in the emergency room. They just won't pay for a hospital bed until one opens up at one of the already approved facilities.
So, what is the minimal treatment for emergency room psychiatric care? In Billy's case, because there are no beds available for his particular illness, and because of the limitations of his insurance and his parents' financial resources, Billy is held in the emergency department until a bed becomes available.
In fact, Billy is held in the psychiatric emergency department for three days. That's 72 hours. He is held in a locked room, and is seen daily by the emergency room general psychiatrist and a social worker. He is started on an antidepressant, but he never leaves his room. At one point, after he becomes agitated and frustrated, he is literally restrained to the bed and administered a sedative for his own safety.... The same treatment just wouldn't be tolerated for any other illness.
Remember, this is insurance that the federal and (in Massachusetts) state government is forcing people to buy and is certifying meets the standards for minimum creditable coverage.
