On Sept. 6, the Star Tribune reported that Blue Cross and Blue Shield of Minnesota is cutting payments for mental-health therapy (“Blue Cross cuts therapy payments”). Here are 13 reasons why that action by Minnesota’s largest health insurer is shortsighted:

1) It violates parity for mental-health disorders as compared with physical disorders, and is discriminatory against people with mental-health issues.

2) In the 30 years I have been practicing, I have watched the level of self-destruction in children steadily rise. When I first started practicing, I had no children on my caseload who were “cutters.” Now, roughly 20 percent of the kids with whom I have the privilege of working self-harm.

3) Suicide is the leading cause of death among people ages 15 to 24.

4) Drug and alcohol use has increased drastically.

5) Apparently the Minnesota Department of Human Services is no longer demanding that insurance companies meet or exceed Medical Assistance rates of reimbursement, therefore decreasing the service payments to providers dramatically. This is a slippery slope, and not just for providers of mental-health services.

6) Bullying has become an epidemic.

7) At least 30 million people of all ages and genders in the United States suffer from an eating disorder.

8) Twenty-five percent of 13- to 18-year-olds have mild to moderate anxiety.

9) Decreasing reimbursement rates will discourage people from entering the field, which is already short-staffed, and in rural areas, direly so.

10) According to the National Alliance on Mental Illness (NAMI), it is estimated that up to 15 percent of men and 30 percent of women incarcerated in our prison systems are there due to myriad forms of untreated mental illness. It is far costlier to incarcerate than to provide mental-health services.

11) Providers of mental-health services will be forced to return to a “fee-for-service” model, in which clients pay up front and then seek reimbursement from their insurance companies. In effect, this divides mental-health treatment into those who can afford it and those who cannot.

12) Allowing Blue Cross and Blue Shield to slash reimbursement rates for mental-health services sends a message across the insurance industry that it is OK to do so.

13) The number of school shootings in the last 30 years has increased alarmingly. As a provider of mental-health services, I can no longer tolerate the lip services and platitudes uttered by legislators and community leaders at countless tragedies that could be prevented if services were more readily available. Stand up and do something about it now.


Karen Miller, of St. Paul, is a clinical psychologist.