A new low for insurance in US.

Insurance companies are in the business to make money, not spend it, so it makes sense they would try to get out of treating an eating disorder. Money talks, B***s*** walks. Sadly, this seems to be just another example of twisting the legal system to avoid living paying out profits.

Does a court really need to dissect some poor kid's miserable diary entries to figure out if a disease is biologically based?

Diary entries, no. Facebook is a public web site. If you post stuff for the public to see, you should expect others to see it.

And as the article points out, this ruling actually reduced the scope of an earlier ruling, such that only information published to public websites fell under discovery.

Wow, that's messed up.

I would SO sue for invasion of privacy. Total bullshit.

I think it should be covered. If the body is malnourished and too small, that's biological, no matter the root cause.

@aaron8301: Check the user agreement for these sites - I'd be surprised if there was any guarantee of privacy. This is different than having text files on a web server that you SSH into.

What does it mean for a mental disorder not to be "biologically based"? Does Horizon Blue Cross Blue Shield believe in Cartesian dualism?

none of this surprised me anymore.

You know what is next ?

2011: (Insurance lawyer in front of a packed court room)

" Mr. Snarkysnake, I see here by your supermarket loyalty card that over the last 4 years you have purchased over 200 six packs of Old Milwaukee beer,over 190 packages of Oreos and countless "party size" bags of Lays Potato Chips. Can you tell the court why Purple Cross/Purple Shield should pay for the stent that you CLAIM is needed to save your life "?

Mr. Snarkysnake: "Aggghhh ! My heart "! (gasping for air)

See how easily we GIVE our rights away ?

This is an outrage! I'm a firm believer in the "if you don't want it to be read by EVERYONE, don't post it" rule, but I doubt most teenagers would have the forethought to wonder ahead of time if they might be compromising their legal positions in future litigations with insurance companies before they post to MySpace or Facebook etc. etc.

This is a perfect example of how insurance companies take your premiums every month and then when you need them to pay a claim are willing to use every excuse in the book (and as this story indicates, invent entire new ones!) to avoid having to pay up.

With insurance you get what you pay for. If you're only covered for "biologically based" illnesses, then mental illness isn't covered. Fair enough to use PUBLIC records to establish whether or not the illness is actually covered by the insurance policy.

Of course, if you want the insurance companies to pay for every claim, then it wouldn't matter if the root cause of the illness was biologically based or not. Hope no-one minds paying much higher insurance premiums though. And those that can't pay the higher premiums would have no cover at all. Unless they opted for insurance that had some specific exclusions, for example mental illness. Hey, that's what they have already!

Welcome to capitalism!
No wonder the world hates us- I hate us too!

@snarkysnake: :jaw drops: I bet you're 100% right! Maybe I should rethink how much that $10 or so I save at the grocery store every weekend is actually worth to me...

Doesn't this fall under the category of psychological illnesses which would be covered anyway? Something like this can be biologically based and it is difficult to determine that factor. It can be anything from hormones to a thyroid condition.

@humphrmi:

If it is set to be private does it still apply? That would mean you would show it only to those you wish to see it. Public when regard to a diary would be like you publishing it in a newspaper, if you have it so only those you want to see it can, that it straight privacy there. Shame on this judge for invading her privacy.

@snarkysnake: "Aggghhh ! My heart "! is exactly what I'm thinking after considering the implications of your post along with the Intelius story.

My new personal mission is to wipe myself out of every database in existence (or at least provide enough false information to confuse the hell out of anybody trying to track my behavior). Of course, since being dead is not even enough to get out of a cell contract, my efforts may have little effect.

@dragonflylotus:

Heres a tip : Go to www.nocards.org and read up on this. Best of luck in getting out of the datebases...

Why is anyone surprised at this? When you post on the internet, you're posting for the world to see, regardless if the people who see it are your girlfriends or scumbag insurance companies. Here's a hint: instead of whinning about your food problems on myspace, talk to your parents or *gasp* your doctor about the problem; if they were subpoena'ed than that would be invasion of privacy.

Kind of sad, but it's great for the peek it provides into our broken system. As an issue it'll generate plenty of emotion and mail for the politicians.

what would happen if everybody who has health insurance suddenly dropped it? like, on the same day?

Sorry to say, but many mental illnesses are considered a "biologically based disease." Various eating disorders can be influenced by things such as major depression and bi-polar disorder - which are considered "biological." Regardless, eating disorders are very serious and for an insurance plan to not treat any disorder classified in the DSM (bible for psychiatrists and mental health workers) should not be allowed unless pre-established by the insurance coverage.

UGH! Ya just gotta love it when insurance companies do everything under the sun in an attempt to weasel out of doing what they were paid to do.

this is disgusting.

@dragonflylotus: Somebody ought to start a social networking site called WrongSpace.com, for people who want to lay out as much disinformation about themselves as possible.

If it's in writing and it's available to anyone but a person with the legal responsibility of confidentiality to you, then it can be subpoenaed. You really have to have an expectation of privacy to claim it. That said, I keep no diaries and I never write anything that remotely resembles a threat or malicious intent. Never write or say anything that can be seen as something that can be held against you should you or someone else come to harm. With the openness of the internet, there is no expectation of privacy.

@enoughwealth: what? mental illness is not biologically based? our brains are actually computer hardware? how about that.

Meghann! I could be wrong, but shouldn't that be "subpoena" and not "subpeona"?

Biological illness, I think, refers to attributes you can have physical evidence of. CT scans, MRIs, etc. Psychological illnesses are things that have roots in beliefs or perceptions, like anorexia. Psychological illnesses often intertwine with biological because psychological illnesses often cause biological symptoms. Depression is a psychological illness but some of the things that go along with being depressed, like insomnia (for some people), headaches, those are biological.

In the case of anorexia, the illness (I believe) is psychological in nature. An extremely thin person might not be anorexic but other biological clues (wearing down of the esophagus from vomiting, unhealthy, gaunt features) give indication that a person who is very thin but looks physically unhealthy may be anorexic.

@aaron8301: How is it an invasion of privacy if the documents are published on your myspace? And who exactly are you going to sue? The judge is compelling this disclosure and you certainly can;t sue him.

Do they treat alcoholism as being "biologically based"? Every alcoholic I've ever met has said "I love drinkin'"

@rhyss: Sorry to say? And what's with the quotation marks? What are you, a Scientologist?

Just one more reason why I dropped all my health insurance. I'm just taking that cash that I was spending on insurance, sticking it into my savings account and I'll just let the chips fall where they may.

@Randy: Actually, Horizon Blue Cross Blue Shield is a "not-for-profit organization". So at least according to them, their goal is not to make money.

@D-Bo: Don't forget, the only reason the judge is compelling this is cause the PARENTS brought suit. When you sue you give up all rights of privacy since the defendant can ask for disclosure on any even marginally relevant information.

Wouldn't it be catastrophically traumatic for children suffering from mental conditions, when a faceless corporation that was supposed to be helping them, mercilessly violates their privacy, slits its throat, chops it into pieces and throws it into a ditch? I can't imagine a more perverse course of action for a health insurance company to take than forcing children into court and exposing their most private writings.

It doesn't matter if they posted it on a portion of the internet that is, technically, public. That won't make them feel any better about it. You really think every kid using social networks operates under the assumption that one day, everything they write will become part of the public record when an insurance company takes them to court?

The fact that they would even try to pull this shit is unforgivable.

Allowing a disease such as anorexia to go unchecked is infinitely more costly in the long run to the insurance company than dealing with it in the short term. This aspect of our health insurance system is unfathomable to me. When you look at the simple economics of the situation, providing coverage for her just makes sense. Another example that immediately pops into mind is the unwillingness of insurance companies to pay for smoking cessation treatment such as Chantix, or even the patch, gum, or lozenges.

And that's not touching on the "New Jersey law requires coverage of mental illness only if it is biologically based," part of the article. Anybody who is an expert on the subject, feel free to correct me if I'm wrong, but have we even reached a consensus about the role of biology in causing mental illness? How exactly are we supposed to determine this on a case by case basis? Especially given the extremely loose interpretations one could take on either end of the spectrum.

It's a civil litigation matter if the insurance company chooses to make it one. This is a typical discovery request and is par for course.

That's not to say that the extended level of doucehbaggery on part of said insurance company isn't disgusting.

A therapist I know actually encouraged me not to tell anyone on the internet about my health, physical or mental. Horror stories like this one are pretty common. She has young patients with what insurance companies and the government call "mental deficiencies." (Psychosis, eating disorders, etc.) She said some of her patients have made the mistake of contacting their teachers and professors about their mental illnesses. It went on their files at school and now they can't get insurance.

The state of our mental health system is so sad.

@smitty1123: Great! When the chips don't fall your way, the rest of us will be glad to pay for you.

There are a ton of "pro-anorexia" communities on Livejournal so this doesn't really surprise me. It's highly unfortunate that people who are suffering and choose to write about it online are being punished but I can't help but think the people that call themselves "ana" and ask for tips on how best to not pass out while they only drink water all day are at least somewhat to blame for insurance companies being wary.

Myspace and facebook-- yeah, that's okay as long as you can prove that that profile belongs to the person in question.
Looking at a diary or personal emails? Not so much I think.

It appears that health insurance companies are now taking the no-more-privacy green light from government and morphing on into using fascist-based excuses to advance their bottom line, when and wherever they feel like doing so.

Interesting, since I believe there was a study that came out a year or two ago that had some of the first evidence of there being genetic predisposition to eating disorders. The research is in an early stage, but it's there.

The general consensus (amongst those who are neither Scientologists nor Freudians) is that, to a significant degree, mental illness has a biological basis - chemical imbalances, genetic wiring - in what is considered more "extreme," like schizophrenia, there is, in fact, visible evidence on a brain scan.

I'm not really sure what evidence BC/BS is trying to get here, either. Are they just trying to prove that these girls have eating disorders? Is it necessary, then, to take actions that could have very negative psychological ramifications? Or are they going to claim that a 14-year-old girl claiming that she's happy this way, she wants to be this way, and she behaves in ways that make it worse, somehow means it's not biologically based...?

I used to have Horizon Blue Cross/Blue Shield in NJ. I also have a generalized anxiety disorder marked by panic episodes and obsessive-compulsive behavior, and major depression. These problems manifested themselves in an eating disorder. Thank god my psychiatric treatment was through a no-cost program at a med school, but I wonder now if they'll even threaten to stop prescription coverage for psychotropics provided as a part of treatment.

It's obscene. People post to myspace and the like, usually obscuring their name, address, etc. Hence there IS an expectation of privacy.

Ugh, I'm surprised that people have failed to mention that a user's Facebook profile is NOT open to the entire public. Only users within that person's network have any access to a person's profile, and much of the content is only available to user's friends by default.

With the myriad of privacy controls on Facebook, the website doesn't intend a uesr's content to be disseminated to everyone.

This is highly disturbing.

I thought that anorex