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View Diary: Guns, mental health and Obamacare (90 comments)

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  •  read the bill's text more closely (2+ / 0-)
    Recommended by:
    annieli, raincrow

    the gun provisions only apply to "wellness and prevention programs," not private counseling, or even regular doctor visits.



    26 A wellness and health promotion activity implemented under subsection (a)(1)(D) may not require:

    2 the disclosure or collection of any information relating to—
    4 ‘‘(A) the presence or storage of a lawfully possessed firearm or ammunition in the residence or on the property of an individual; or
    7 ‘‘(B) the lawful use, possession, or storage of
    8 a firearm or ammunition by an individual.

    here is what subsection (a)(1)(D) is all about:

    (b) Wellness and Prevention Programs.--

    For purposes of subsection (a)(1)(D), wellness and health promotion activities may include personalized wellness and prevention services, which are coordinated,
    maintained or delivered by a health care provider, a wellness and prevention plan manager, or a health, wellness or prevention services organization that conducts health risk assessments or offers ongoing face-to-face, telephonic or web-based intervention efforts for each of the program's participants, and which may include the following wellness and prevention efforts:

                ``(1) Smoking cessation.
                ``(2) Weight management.
                ``(3) Stress management.
                ``(4) Physical fitness.
                ``(5) Nutrition.
                ``(6) Heart disease prevention.
                ``(7) Healthy lifestyle support.
                ``(8) Diabetes prevention.

    how likely are guns to come up in a convo about diabetes, anyway?  stress is the only thing that would be remotely relevant to guns, and you can bet yer bippies wellness programs don't go that in depth.  

    Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

    by Cedwyn on Wed Dec 19, 2012 at 10:07:46 AM PST

    •  But could (9+ / 0-)

      certainly come up in discussion of "stress management," or "healthy lifestyle support."

      Discussions, within the context of a wellness session, that will be occurring with a physician.

      The point remains that none, none of these provisions are necessary, that gunowners' rights are a completely superfluous thing to be inserted into a health insurance reform law.

      They're there because the gun lobby wanted to prove they could be them there.

      "There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning." —Warren Buffett

      by Joan McCarter on Wed Dec 19, 2012 at 11:00:09 AM PST

      [ Parent ]

      •  Yup Patient is totally 100% healthy (7+ / 0-)

        but they live with someone who has, say, a mood disorder or addiction?

        Is it safe to ask if they have guns?

        Gynocologists and PCPs often get into these sorts of convos with women. At least mine have. They asked and knew when I was dating/living with guys who had mood disorders and they asked if there was anything dangerous in the house,  specifically a gun, that we needed to worry about.

        They weren't worried about domestic violence because there was never any of that in my case, but just that "you never know" thing that very attentive physicians worry about.

        That's not allowed now?  Swell.

        © grover

        So if you get hit by a bus tonight, would you be satisfied with how you spent today, your last day on earth? Live like tomorrow is never guaranteed, because it's not. -- Me.

        by grover on Wed Dec 19, 2012 at 11:34:56 AM PST

        [ Parent ]

        •  it is totally allowed (0+ / 0-)

          "wellness programs" are not part of regular care.  the legislation is not talking about private counseling, or even regular doctor visits.  

          read the legalese again; the prohibition has very limited application.

          Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

          by Cedwyn on Thu Dec 20, 2012 at 08:52:43 AM PST

          [ Parent ]

    •  "Stress management" = 'Mental Health", (2+ / 0-)
      Recommended by:
      Williston Barrett, lotlizard

      Cedwyn.  As in depression, anger management, suicidal thoughts, agitation, do we need to put you on psych meds.

      So the questions (from docs or in checklist/questionnaires) couldn't include 'Any guns in the house?' as a follow-up to questions about suicide, etc.

      Yes, the first quote you gave proscribes " the disclosure or collection of any information relating to".  In practical terms, that will come out to the medical personnel being told 'don't even ask -- they could sue us'.

      •  i've participated in "wellness programs" (1+ / 0-)
        Recommended by:

        for insurance purposes.

        and i am here to tell you they just don't go that in depth.  lotta questionnaires and websites with info to read.  feeling stressed?  make sure to get good sleep and exercise more!   yadda yadda.  

        Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

        by Cedwyn on Thu Dec 20, 2012 at 08:46:54 AM PST

        [ Parent ]

    •  I always asked my patients or their parents (5+ / 0-)

      when I was a mental health counselor in private practice this question, "do you have firearms in your home and how are they stored?"  Anyone with a mental health issue should not have access to any firearms.  Period.  I started doing this after I had one session with a 20 something who was despondent after his girlfriend broke up with him.  2 days later I opened the newspaper to see his picture-he was lying prone on the hood of his car with a rifle pointed under his chin, outside his girlfriend's home.  Police talked him down. He was hospitalized.  

      •  yes, counseling in private practice (0+ / 0-)

        you would not be prohibited from asking the question.

        all this precludes is generic wellness programs from asking those questions of participants.

        Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

        by Cedwyn on Thu Dec 20, 2012 at 08:48:26 AM PST

        [ Parent ]

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