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Commentary | VOICES / A FORUM FOR COMMUNITY ISSUES

Equalize Mental Health Insurance Coverage

June 08, 2002

Mental illness costs the United States almost $300 billion a year in criminal justice, social welfare and other services, according to the National Institutes of Mental Health. The costs in suffering of individuals and their families are incalculable. The so-called mental health parity bill would require that health insurers offer equal payment for the treatment of certain mental illnesses. The measure is working its way through Congress. RITA LUTHER spoke with an advocate in the mental health community about the measure.

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RICHARD VAN HORN

President, Los Angeles County Mental Health Assn.

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The Mental Health Equitable Treatment Act is worthy of our support because it increases the number of working people who will benefit. It mandates that businesses with 51 or more employees abide by these new requirements. The measure applies only to group health plans already providing mental health benefits. It would not require plans to offer such benefits.

Specifically, the proposed bill would provide parity [with coverage for physical illnesses] for the number of hospital days and outpatient treatment sessions for people receiving mental health treatment.

Having a mental health disorder can be as serious as having a broken leg or cancer or any other physical illness.

A young man in my family was diagnosed with schizophrenia some years back. He needed treatment, both hospital and ongoing. However, he ran up against the limits of his insurance within a month--he had a not-uncommon lifetime cap of $10,000.

When the $10,000 had been paid out in the initial hospitalization, it was up to the family, which could ill afford it, to pay out of pocket until their liquid assets were used up and he could qualify for Medi-Cal.

This measure would extend full parity to all individuals with a condition listed in the Diagnostic and Statistical Manual of Mental Disorders.

This manual is the recognized authority, accepted and routinely used by the insurance industry and health-care providers alike.

By using the industry standard as our guide, we prevent further discrimination against the mentally ill, while providing the insurance companies with reasonable parameters for plan administration.

While we see this bill as a positive step, we believe more has to be done to protect people with mental disorders and their families. Because the public sector programs paid for by state or county departments of mental health have been more involved with people with disabling mental illness, they have engaged in a wider variety of treatments than the hospital or office visit options normally available to the insured population.

Public systems have been developing integrated-care systems to try to get people back to normal living in the community.

The public systems have produced better outcomes than many of the privately funded programs. So, even if the coverage is available, it is going to take time to expand the treatment options to bring it up to the level of public programs and to include a new group for coverage.

Further, we are not sure just what level of care President Bush is supporting by coming out in favor of the Mental Health Equitable Treatment Act. There is a rather generalized suspicion in Washington that he is willing to trade down to a narrower group of covered disorders.

[The president said that the mentally ill "deserve a health-care system that treats their illness with the same urgency as a physical illness." He identified inequity in coverage as one of the major obstacles to confronting what he termed "the hidden sufferings of Americans with mental illness."]

There is some fear in the advocacy community that he may bargain for a narrower bill only covering a short list of the most severe illnesses that cause people to be disabled.

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