A Kaiser Health News sampling of the latest headlines about Obamacare reflects our continuing anxiety over the law just months before it is fully implemented.
The most interesting to me was this one. According to a new CNN poll, only 43 percent of the public favors Obamacare. But of those who oppose it, only 35 percent do so because it is too liberal. Sixteen percent say that it is not liberal enough!
No matter how you feel about Obamacare, one of the most significant changes it facilitates will be the integration of health and behavioral health care - meaning that care for both physical and mental illnesses will soon be delivered together.
This only makes sense. People with cancer, for example, often develop depression or anxiety that complicates their care. And people with mental illness often develop physical conditions - sometimes as a side effect from the medications they take - that can cut twenty-five years from their lives.
Integrating health and behavioral health care has not been the norm over the past century.
In a nutshell, this is because regular health care evolved from an acute care model - the idea that we could cure disease with aggressive, short-term interventions. Mental health care evolved from a chronic care model - that mental illnesses could be managed, but not prevented or cured.
What we have learned in the last 20 to 30 years shows that both models can be useful in treating all diseases.
So we began to manage some diseases that we could not cure using a newer chronic disease model. HIV/AIDS treatment is an example, but so are today's treatments for many chronic conditions, including cancers, heart diseases, diabetes, and hypertension. And we began to use an acute care model to treat mental illness, offering short-term stabilization in addition to longer-term therapies.
With diseases co-occurring and treatments often intersecting, care integration was the logical next step. Read More