Welcome to show we're done. This year -- your time and portable health care act obamacare. We're doing because of the limited for a belligerent -- revelation I've been corrupted it's old news but it's for some -- Health insurance companies must cover mental illness. End substance abuse just as they cover physical diseases. And there's always go to experts bedrooms and that with doctor Patrick -- Psychiatry professors whose future for political -- -- -- -- movements and doctor welcomed the short -- -- or is this corrective is that so -- dealers are still being. Where he is said to me in my day you might existed before it actually the first two parity law passed in 1999. This this this law actually passed in 2008. It happened in or rule put in place in 2000 and in this is the final rule. The final rule kind of clarifies some significant issues with it. Interestingly this has ties to the gun violence issue out of the White House the only reason they took this on right now is this is one of the few things they can get through the congress. Since gun control stuff was -- -- starter they went this route. But at least we got it done. YouTube -- -- -- goes some of the deep fields of a couple of -- pulled up over the last couple of and you're right I've forgotten all about it this laws initially stunned and President Bush -- or it's not that -- well. Would now be decided. Obamacare. Will bull also carried them all right. Right exactly it is that a couple months ago they are making a big deal people might have missed this they were talking about the ten essential benefits. Ethnic and anyway one of the ten essential that this was mental health coverage in dirty -- -- Other health care issues. Other other essential benefits from things like preventative care birth control like that. And in 2000 native remember -- The parity and wall. Strictly a large group plans but it didn't require. The payroll for mental health coverage is is this now going to be required. And if it will be required. For the individual plans to the exchanges in the small group plans -- the exchange it will be record. A lot of the cancellation -- people are getting. Probably is because. Spot individual plans to small group plans currently have to cancel their policies to -- to bring it up to this level. And that's what people in these cancellation notices. But. It doesn't is that it's is that insurance company offers. Mental health services that doesn't require it but if they offer it has to be exactly the same as non. Mental health care about the rest helped. The human when introduced question but as a doctor what would you think -- -- -- from. Affordable health terror two. -- requirement -- -- some groups that. Mental illness in the -- and be true it does so in his broken bones what what are -- thoughts is it's. A better today in the neutral -- or -- It's like I haven't given what it differently and I think it's. Then been -- -- -- had discussions with meant oh with insurance companies -- Where after someone tries to commit suicide. On the phone with these people the next day. And then they'd literally asks me whether any bullets -- gone. And if he says no he told the truth very little it is I don't know they would. Use that as a reason to deny coverage I mean they had gotten that. And has remained kind of strange I mean there are exempt groups for instance Medicaid managed Medicaid. So Medicaid done by Magellan for about here locally is is not covered under this section got Weaver. And also Medicare is not totally covered under this Medicare though typically covers things -- To get back to question do what I think about. It's if you get if you're an offer health care. Com. In my opinion. With this severe and chronic mental illnesses especially and also some of the more years but treatable short term illnesses. It makes all the as the world to treat them as aggressively as possible and not on parity because. They actually bring them constable system if you treat them well. If you don't if you don't if you and norm that they actually increased the cost of the whole system -- over and over and over. Interest -- doctor Jim we hold you for a few Mormon should come right -- doctor Patrick McNeil. Psychiatry professors whose future clinical -- too lenient virtues school movements and this is double that of Leo begin at seven more on the -- Britain get -- all law that's actually been in place of Poland's incorrectly all the way back through 2008 when. George W. Bush put in into effect. It's a middle help -- -- -- ruled suggesting that. -- -- paid for in the same degree as we've played virtually anything you broken blown -- that coal. And now we have word that -- obamacare. Has come a -- -- it's finally there insurance companies must cover mental illness and substance abuse. Just as they -- over -- the two -- disease. And -- this we have professor and doctor Patrick mule. So future for the political prayers too lenient words movements and tell me -- -- if it's if it's been lost since 2008. It is that they're making it sound like misses something brand new and it's just being implement. I think one of the reasons well if it would it's it is clear as mud girl and I mean the reality is that we of the law was initially written. And the way is that many insurance companies. Modified their their coverages it. They added things that were it was hard to prove that they weren't. Parity so for instance they -- they would do things like -- tiered levels of providers. Where they've it would require someone to use social worker. And not allow to see a psychologist. Or psychiatrist and therapy for instance. Or or another thing that was very very murky was. A lot didn't specify anything about partial programs her intensive outpatient programs where the majority treatments happening now -- it's. Analog insurance companies took advantage of that and actually just deny them pretty much outright. So and so that's it this is this is a -- Final interpretation. It's like most things you read from Washington over 200 pages long. Com has all kinds. Very detailed descriptions but also some things and left very much up in the year. Good example is is an insurance company -- shows that because of this laud their their. Prices have gone up their costs have gone up 2% in any given year total that search for a further coverage. They can actually apply for a waiver. And so there's some question about whether or not. That out will have an effect so that the via the this is that if they did things that they clarified. And was such a what's happened recently is a lot of organizations in the country actually taken some of the insurance companies to court because. They're there ignoring. -- the parity law. Very hard to prove. What if I understood you correctly boy is this not applicable to Medicare. Medicare. Was waived because it was not to be a cost is a cost concern and that they would have spent more money on this. They would have to take it from someone -- somewhere else and no one wanted to go that book they kick the can down the road that no one wanted to look at what they would do what they would cut. If they increase spending. In mental health or substance abuse for Medicare patients but -- in general -- fairly well. Good benefits. It but it's just not held under the law. And get to four -- the rules violation -- but it bud dude is rumored human problem responders. When the absences from when articles and India. Treatment drug problems as public -- these issues can be just that now. A criminal justice issues. That seems to be more and -- the direction we're going to. This rather strange question whether if human actions can begin to be blamed guns some. Contacts and some -- -- On boring chemicals. And simply by giving them. Another kimco but the -- opium with the electric pro bring him back and as societal. Approval. Is do you see that thing happening more and more in the future and so is that less a -- -- or more. That I -- accident. Yeah I ask me you know that -- question it's it's a difficult one to answer. You know. Do our -- that make. Are we didn't define anything that's abnormal as a as a psychiatric illness so for instance. -- Homicide except her -- that are just by nature of the beast it's abnormal. If -- intoxicated does that modify it means that the reality is. You know I don't think you can pass follows. Putt I apologize all of society's ills. And you surely don't have the treatment that ability it's. You don't have the facilities -- -- empty -- to take these people if indeed they go that route. Actually which is seen as just the opposite as places of close to see an increase in jail in in in and now. Total incarceration in increase in nursing home. Patients so it's very interesting. Like societal issue. Com but -- I've talked to a lot of veterans on this show in person. That -- came back and they said -- guilty -- a lot of it right and we came back in the same frame of mind and had to -- eight not to go out and hurt people because. The actual -- Bible was such a -- rushed. They wanted to do it again in the game and -- lithium electric pro or whatever it in jail -- they they didn't say you're not guilty -- -- did. But they no longer wanted to do is that. Just isolated incidents. You know -- -- and that's our question Garland. -- he would take it take 1820 year old. Vietnam the average ages. -- soldiers Vietnam was like eighteen point six years there's crazy you know. And in years picked -- the young kids like that in to a place where there's no rules and -- let them loose. And then -- brilliant stroke back and stick them on the Streets of San Francisco. 24 are less than 24 hours after the -- the jungle. And you expect and behave differently insists it you know it that we put our people want over the years -- really difficult situations. Kids people that whose brains haven't fully developed immunity at average male brain is not totally developed into almost 25. Or in my case that. Sport. Over I think I was 52. It was a little bit of the -- Aren't more final question again we're real reservations. Huge sell insurance question. The health system we have now. Isn't working. And if it's working is it working good enough it is alleged big. Oh I think it's. And it helped economists would say it's not working and it's not worth the money that -- -- we pay more than anyone else in the world per per person. For healthcare. Including -- uninsured. And our outcomes are worse. If you look at outcomes it's something like we're we're 25 to 26 were behind some. -- the first world countries. So so -- you know the cut and the and and you can use. I've listened to some leadership knows you have economist come on -- just not sustainable either long term that means is it's growing so fast you have to do something. And if you agree with that right and in their correct. Do you let's forget about your views -- the being that anybody's suggested I mean. I'll hear things about. Composition cross strait island state -- and hear things about reducing. Our product -- some. Susceptibility. But read the congressional budget as one of the more on courts rule organizations. And Washington it's it's just minutes to 1% 2%. Over overall cost you see any -- anything with an alternative. To. Let's do away with the Obama here OK now we do -- Well. This is just my opinion it is not to -- Wherever the -- but that that. The other if you read enough about health economics and you read enough about. The places in the in the world that actually have functional systems that -- lasting get better outcomes. They actually hear all of single payers they take profit motive out of it you don't have and she don't have health care insurance as such with with companies make in. Haven't -- stockholders. I just don't know -- you have healthcare system. That. Is viable financially and have. The profit motive as part of that. Doctor real and -- those compensation and or does your production time. Hopefully is this issue continued -- do more into them in the picture churn. -- -- -- -- Professor in doctor Patrick who knew you'll. Psychiatry professors whose future pre clinical affairs. Tulane university's school of -- complicated and it just my school educations struggles with the answer you. Who looked like me you know that dog listening to -- squeal with the had caught wind we believe we over.