Archives - Psychology: Page 4
Author: paul carson (Wed Apr 25, 2007 12:16 pm)
Title: Fairness for mental health
Published: March 24, 2007
After a decade of small-bore measures and frustrating stalemates, it looks as if Congress may be ready to require that insurance coverage for mental illness and substance abuse be provided on the same terms as coverage for physical ailments. So-called parity legislation would be a boon to the millions of Americans who suffer from mental illness or addiction and find it hard to afford treatment. It should also reduce the high productivity losses from depressed or stressed workers.
The Senate and the House should move aggressively to pass this much-needed legislation and send it to President Bush for his signature.
Neither the Senate nor the House versions of the bill would require employers or health plans to cover mental illness. But if they do provide such coverage, the financial terms and treatment limits would have to be the same as they are for medical and surgical benefits. No longer could health plans limit mental patients to fewer days in the hospital or fewer outpatient visits. Nor could they make mental patients pay higher deductibles, co-payments or other out-of-pocket charges than other patients.
The most striking development this year is the broad consensus behind the Senate bill, the fruit of extended negotiations with employer groups and insurance plans that have fought such measures in the past, lest their costs be driven up. The bill is backed by Senators Ted Kennedy, Democrat of Massachusetts, and Pete Domenici, Republican of New Mexico — both long-time champions of equal treatment for mental health — whose staff members worked out the compromise. The final product may not be perfect, but it gives mental health advocates much of what they want.
The House bill, whose chief sponsor is Representative Patrick Kennedy, Democrat of Rhode Island and the senator’s son, looks stronger in some respects. It would require that any plan that covered mental health provide coverage for, at a minimum, the same wide range of mental and addiction disorders that are currently covered by the health plan with the largest enrollment of federal employees. The Senate bill does not say what conditions must be covered, and focuses simply on ensuring equal cost-sharing and treatment limits. That is based on a tactical judgment that the business community would fight broad coverage requirements.
Given that President Bush has endorsed the idea of mental health parity, and that both houses seem poised to enact it, the prospects look good for ending the long stalemate. But the House will need to be careful not to overreach and upset the carefully built compromise that has finally brought recalcitrant insurers and employers to the side of equal treatment for mental health and addiction.
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