Uninsured patients with bipolar disorder and other mental illnesses have limited access to healthcare services because diagnosis, treatment, and management of the disorder are very expensive. Bipolar disorder is a lifetime disorder that requires early diagnosis and appropriate treatment for effective management to reduce mortality rates and increase the lifespan of the patients. According to the National Institute of Mental Health (2009), bipolar disorder is the most expensive mental illness to both patients and health insurance companies because lifetime medical costs per patient range from $11,000 to $600,000 depending on the severity of the disorder (p.7). The lifetime medical costs are very high in that, only insured patients can afford and access necessary treatment and management measures from the healthcare system. Since uninsured patients can neither afford nor access recommended treatment and management measures in the healthcare subsystem, they tend to have high mortality rates that reduce their lifespan. In view of this, the research proposal seeks to establish if significant differences exist in healthcare services that insured and uninsured patients of bipolar receive. Moreover, the research proposal seeks to explore potential justice and social ramifications associated with healthcare disparity between insured and uninsured bipolar patients.
Given that bipolar disorder is a long-term illness that requires proper management, it is imperative that uninsured people receive equal medical services like their counterparts who are insured. It is discriminative for the healthcare system to concentrate on offering better services to insured patients of bipolar leaving other patients uninsured. Seltzer (2007) argues that the existence of disparities in the healthcare system hinges on the fact that physical and mental illness are separate entities that receive funds and experts from different sources (p.1). While healthcare services of physical illness receive effective funding and are accessible to patients, healthcare services that relate to mental illness receive ineffective funding and are hardly accessible to patients with bipolar disorder, particularly uninsured ones who depend on government support. It implies that disparities exist in the healthcare system regarding the delivery of medical services, which involves physical and mental illness. Therefore, the research is going to explore and analyze disparities in healthcare services regarding mental illnesses, especially bipolar disorder and provide the basis of formulating policies to ensure that healthcare services are equitable, accessible, and affordable to all patients with mental illnesses.
The disparity in healthcare services in terms of physical and mental illnesses, as well as insured and uninsured patients, significantly affect treatment and management of the bipolar disorder in any given population. Differential treatment and management of mental disorders and physical illnesses have greatly changed the social perception of diseases. While social perceptions seem to empathize with physical illnesses, they denigrate mental illnesses thus putting more strain on bipolar patients, caregivers, and their families. Such stigma isolates bipolar patients from receiving proper treatment and management of their condition. National Institute of Mental Health (2009) states that inadequate treatment and management of bipolar disorder have great social ramifications because it can lead to increased abuse of drugs, instability in families, reduced functional status of patients and extended burden to families and caregivers, which is quite stressful (p.22). The great social ramifications warrant changes in policies to ensure that uninsured bipolar patients have equal access to healthcare services as their insured counterparts thus enhancing social equity in the healthcare system. Moreover, poor treatment and management of bipolar disorder due to unaffordable and inaccessible medical services have legal implications, as there will be increased cases of drug abuse, suicidal incidences, and criminal activities arising from manic episodes of the disorder.
Bipolar disorder is a psychological disorder characterized by intermittent moods and energy levels thus affecting the ability of a patient to function normally. The disorder affects neurons in the brain, hence causing uncoordinated functions of the same. The functions of the brain depend on the intermittent moods of depression and mania that characterize the disorder. Variability in manic-depression moods affects the cognitive ability of an individual, elicits fears, distorts rational thoughts, causes great trauma, and development of suicidal feelings. The disorder mostly affects adults, while some cases occur in children due to the heritable nature of the disorder. According to the National Institute of Mental Health (2009), bipolar disorder ranks sixth as one of the causes of disability across the world and prevalence studies carried out by the American Psychiatric Association show that approximately 1.5% of American adults suffer from bipolar disorder (p.17). With the disparity in delivery, affordability, and accessibility of healthcare services related to bipolar disorder, trends are likely to worsen due to poor treatment and management measures that uninsured patients with bipolar receives.
Proper diagnosis, treatment, and management of mental disorders are very critical aspects of healthcare services that need urgent attention so that uninsured patients can afford and access medical services. The uninsured patients are not only receiving limited medical services from the healthcare system, but also inconvenient services that do not save their lives in cases of emergency. Studies have shown that separation of physical and mental illness in the healthcare system is to blame for poor treatment and management of mental disorders, particularly bipolar disorder. Initially, separation of physical and mental illnesses was meant to increase efficiency in healthcare delivery due to the specialization of medical experts, but it has resulted in immense discrimination against mental illnesses. Consequently, patients with mental illnesses have received poor attention not only from government funding but also from healthcare systems causing a tremendous increase in their mortality rates that reduce lifespan. Seltzer (2007) argues that patients with mental illnesses such as bipolar disorder, schizophrenia, and other mental conditions are prone to die 25 years earlier as compared to the general population (p.1). Therefore, if appropriate measures are not put in place to ensure that uninsured bipolar patients receive affordable, accessible, and equitable medical care, it means that their mortality rates will continue to increase and their lifespan will decrease abnormally.
Despite great efforts by the healthcare system to improve mental health across the United States, rural areas inhabited by the poor still experience high cases of mental disorders including bipolar disorder. Given that uninsured bipolar patients are mainly the poor who cannot afford to subscribe to medical insurance, they live in rural areas where healthcare services are not only inaccessible but also unaffordable. Since mental illnesses demand a great deal, of medical services given that, they are hard to cure and expensive to manage throughout the lifespan of a patient, the uninsured patients of bipolar suffer greatly. According to a study by Gustafson, Preston, and Hudson (2009), over 50% of calls emanating from rural areas report mental cases of sicknesses and high rates of suicides as compared to urban areas in spite of the similarity of mental disorders (p.2). Hence, the disparity in cases of medical needs and suicides clearly portrays that uninsured bipolar patients have limited access to health resources as compared to their insured counterparts. Lack of medical insurance or insufficient money limits bipolar patients from accessing recommended treatment and management measures of the disorder. As aforementioned, the cost of treating and managing bipolar disorder ranges from $11,000 to $600,000 depending on the severity of the disorder; that is, whether acute or chronic. This means that affordability and accessibility are very important in addressing bipolar disorder in uninsured patients.
Bipolar patients also experience challenges in becoming eligible to Medicare for federal law bureaucracy stipulates that they have to wait for a period of two years for medical insurance to take effect after receiving Social Security Disability Insurance, which certifies their mental disability. Since the bipolar disease progresses gradually, a period of two years without appropriate treatment or management intervention is too long for a patient to retain a good health condition. Various studies have shown that proper prevention, treatment, and management of bipolar disorder need early diagnosis and timely curative measures. In this instance, a period of two years waiting for the medical cover to take effect has detrimental effects on the lives of patients with bipolar disorder. William, Dulio, and Claypool (2004) argue that waiting for a period of two years for Medicare insurance to take effect poses great difficulties to the uninsured patients since they continue suffering irrevocably; consequently, they receive irregular healthcare services that are insufficient and place extra burden on their families and dependents (p.8). Such bureaucracy in federal law inhibits timely accessibility of healthcare services by patients with bipolar disorder who are uninsured and therefore limits the accessibility of healthcare resources in the treatment and management of mental disabilities.