Depression Means No Health Care Insurance: Sorry About That


medical insuranceI fall into the category of the “uninsurable.”

It doesn’t matter that I wake up most mornings to swim 160 laps, am borderline obsessed with eating salads and whole grains, and that I haven’t drank a drop of alcohol in 24 years; that I do yoga twice a week, keep a mood journal, engage in cognitive behavioral therapy, and have a rich spiritual life; that I take omega-3 fish oil capsules, vitamin D, calcium, and other supplements with my extra-pulp juice in the morning; or that I work really hard at communicating anger, frustration, and disappointment so that the repression of feelings doesn’t end up as a tumor somewhere inside my body.

I can’t get an individual or family plan short of signing up for a $10,000 deductible.

Because I have a history of depression.

My illness falls under the ABCs of the non-insurable, the “preventable” illnesses that solicit the red flag of “no way in hell” she’s getting coverage:

A – Asthma (and, hell, let’s throw in Arthritis)
B – High Blood Pressure
C – Cardiovascular Disease (and Cancer, sometimes classified – I know – “preventable, ” but which is surely a insurance-killer)
Double D (think bra size) – Diabetes and OF COURSE Depression

Now I’m not so naïve that I dismiss the economic toll these illnesses take on an already fragile economy. Here’s the chronic disease price tag, estimated annual direct medical expenditure, according to the Center for Disease Control, which used different methodologies in calculating costs:

Cardiovascular disease and stroke: $313.8 billion in 2009
Cancer: $89.0 billion in 2007
Smoking: $96 billion in 2004
Diabetes: $116 billion in 2007
Arthritis: $80.8 billion in 2003
Obesity: $61 billion in 2000

Not mentioned here is clinical depression, which, left untreated, is as costly as heart disease or AIDS to the US economy, according to Mental Health America, costing over $51 billion in absenteeism from work and lost productivity and $26 billion in direct treatment costs.

Depression tends to affect people in their prime working years and may last a lifetime if untreated. According the MHA:

  • Depression ranks among the top three workplace problems for employee assistance professionals, following only family crisis and stress;
  • Three percent of total short term disability days are due to depressive disorders and in 76% of those cases, the employee was female.
  • In a study of First Chicago Corporations, depressive disorders accounted for more than half of all medical plan dollars paid for mental health problems. The amount for treatment of these claims was close to the amount spent on treatment for heart disease.
  • The annual economic cost of depression in 1995 was $600 per depressed worker. Nearly one-third of these costs are for treatment and 72% are costs related to absenteeism and lost productivity at work.

That’s not to mention the human toll: seven out of ten deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year. Almost 15% of those suffering from severe depression will die by suicide

And there is much we can do to prevent it. Four culprits are responsible for much of the illness, the suffering, the costs, and the early death associated with chronic diseases:

  • Lack of physical activity
  • Poor nutrition
  • Tobacco Use
  • Excessive Alcohol Consumption

But allow me to climb back unto my soapbox. It’s still not fair. It’s not fair to those of us that go to great lengths to pursue healthy living and do everything in our day in the name of recovery – those of us that get up every morning with a pair of boxing gloves on, ready to fight for our health. It’s just not fair and it’s wrong.

I look forward to my meetings with health insurance brokers less than I do my yearly pap. As much as I try to mentally prepare myself for the blow – “Repeat to yourself: You’re not going to like what you hear. It’s going to be unfair. You need to stay calm” – I still leave infuriated, which then, of course, has me checking off two of the ABCs: depression AND high blood pressure. That would probably bring my deductible up to $12,000, God forbid.

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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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6 Responses
  1. Ok I will not pretend to understand your healthcare system but I do know from what you’ve written that is sucks. It sucks balls (and not in a good way). We’ve had Medicare (which basically covers every Australian) since the late 70’s. I’m critical of our current government but when I look at other countries, by god am I lucky to have been born here.

  2. Tracy Mitchell Griggs

    I was thinking you must have posted this last year – you live in a state that has expanded coverage and is offering subsidies – this began yesterday, October 1. Your general stats represent what WAS. And the advice is good about things to “do” to mitigate top illnesses and things to “do” to help with depression.

    Why did you not post something positive about what the Affordable Care Act WILL do for people with mental health challenges??

    And Affordable Care also offers PARITY, treating mental health the same as physical illness – the first time ever. I hope your next blog post is more positive and speaks to these items.

  3. Mary

    I’m no expert on Obamacare, but I think that Therese has a point. She would be accepted most likely in the new plans, but it could still be very costly and perhaps even more than her current plan. Most people I have talked to who are currently insured find that their plan, although very high, is less than what they found on the new market place. In other words, preexisting conditions will be costly regardless and like your current plan, prices are likely to increase yearly.

    1. Theodore Detjen

      The Affordable Care Act does not permit insurance companies to deny coverage for pre-existing conditions. In addition, it allows people to join groups rather than apply alone, giving them many more affordable choices for HealthCare. It will benefit all Americans to have everyone under some healthcare plan.