A young adult male recently called me at my office, upset. He had just married and, being a responsible young person, he decided to purchase life insurance. What upset him was that he was unable to obtain his policy at a preferred rate. The reason for the higher rate, it was discovered, was that he once had a mental-health diagnosis.
This young person was seen by me about 15 years ago, when he was 12, for the diagnosis and treatment of an attention-deficit disorder. His parents used their health insurance to pay for the consultations.
The young man was perturbed and asked what I could do. I could only suggest that he undergo another evaluation to document that his problem during his pre-adolescence is of no consequence now.
I had another similar case a year or so ago when I saw a couple for marital counseling. The husband was the "identified patient" and their health insurance was used. I saw the couple for several sessions and all went well.
The husband was employed by a large company but for years he dreamed of working for himself. Several months after the marital treatment, he and his wife agreed that he should quit his job and start his own consulting business. When he looked into securing health insurance for his family, two plans rejected him and one plan accepted him - at a rather high rate - under the condition that he would not be covered for any mental-health problems for the next two years. The exorbitant health-insurance rates ultimately dissuaded him from starting his own business.
What both gentlemen failed to realize is that once you use your mental-health insurance, a permanent trail is left. About 1,000 insurance companies across the nation pool their data in the Medical Information Bureau, an association of U.S. and Canadian life-insurance companies that provides medical records information to the financial services industry. When anyone applies for just about any kind of health, life, or disability insurance, etc., in the fine print they are giving their permission to that agency to share information with, and receive information from the bureau. Your "confidential" information in that databank could come back to bite you - as seen in the above true cases.
Unfortunately, the lack of confidentiality with regard to mental-health records is even more extensive.
Routinely I have patients who apply for short- or long-term disability or worker's compensation. The covering agency accordingly requests records from that patient's treating sources. What most patients fail to appreciate is that the agency is not satisfied with the dates of service and diagnosis. The agency demands the actual treatment record, which may well include very private information that most likely has nothing to do with the claim. However, if the patient or provider balks at sending the information, the claim is simply denied.
Sensitive information is usually handled carefully by health-care providers, especially by mental-health providers, particularly since the Health Insurance Portability and Accountability Act was instituted. However, once patient data leaves the provider's office and goes to the carrier, there is no guarantee the data will be handled carefully and only authorized individuals will have access to it. As we know well in the Valley, health-care plans come and go. Patient information, therefore, is regularly being transferred from one plan to another.
Over my nearly 30 years in practice, I have been contacted several times by various federal agencies to explain why an applicant sought my services - perhaps years or decades ago. Executive promotions and political appointments could also be jeopardized by mishandled "confidential" data.
I strongly suggest that those seeking short-term assistance, such as marital counseling, parenting guidance, situational guidance, stress management or personal-growth counseling, should consider paying cash for the service and not activate their insurance. In this way we can be assured that our personal information remains truly confidential.
Larry F. Waldman, Ph.D., ABPP, is a licensed psychologist who has practiced in the Paradise Valley area for nearly 30 years. He works with children, adolescents, parents, adults and couples. He also does forensic work in the areas of family law and personal injury. He is the author of "Who's Raising Whom? A Parent's Guide to Effective Child Discipline," "Coping with Your Adolescent" and "How Come I Love Him but Can't Live with Him? Making Your Marriage Work Better."
