Mental Health Parity and the 2008 Campaign

( – promoted by buhdydharma )

Since no one over at the main Kos site seems to care about anything other than Palin, here’s a cross post…

For those interested in the Native Americans of Southern LA, I’ll post on that tomorrow…however, this is another issue that burns me up, so here’s the rant on this…

It’s a complex issue, but I’ll try to make it short and bittersweet. Mental health issues are not treated like physical health issues by insurance companies. Despite the fact that neuroscience has now clearly linked many mental health disorders like depression, bipolar disorder, PTSD, ADHD, etc. to genetic issues or chemical imbalances, these are still considered conditions that do not merit the same level of coverage as physical health issues like cancer. Why? Because it would cost more money…the health insurers generally treat these as they did in the 1970’s, offering limited if any…coverage. However, some organizations are working to change this amongst insurers, but most importantly, services similar to The Mindful Therapist are looking for ways to change the stigma around mental health disorders by giving a voice to those who are suffering from them.

You can go to the National Institute of Mental Health website for the stats..I won’t bore anyone with them here. However, they indicate that 13 million Americans have some form of debilitating mental health issue and nearly 60 million have a mental health issue of any form. As with other forms of health care, minorities and the poor suffer more from these issues–often due to a lack of care–than other population groups.

Further, this should not be a Red or Blue issue, as anyone, from any background can develop a disorder. For example, I have a good friend who developed schizophrenia while in college. He was from a well-off family, had attended a very good private college prep school and was enrolled in one of the top universities. He started developing symptoms in his sophomore year. He dropped out, and fell into a spiral that eventually found him homeless or in jail. He was eventually able to get help from somewhere similar to the Honey Lake Clinic and now lives a precarious, though stable, life on disability. He is one of the lucky ones, as he had family and friends who gave a shit. Others aren’t so lucky in their support.

Mental Health Parity has been a rallying cry amongst MH practitioners for years. Essentially, this would require insurance companies to treat MH issues as they would physical ailments or injuries. Currently, either coverage is not allowed, or it is very limited. Even a good plan may limit the number of therapy or psychiatric visits in a year and have high copays. The first Mental Health Parity Act was introduced by Senator Paul Wellstone. There have been provisional bills past as well as many revisions and iterations of related legislation. Many states have enacted their own laws, but to date there has not been a ratified act.

A much more comprehensive measure passed the House this year, sponsored by Patrick J. Kennedy. However, the Senate has stalled the legislation over partisan (i.e., GOP) concerns that this would put an undue burden on “small” business owners and would cause a raise in taxes.

So, where have the candidates been on this?

Obama was part of the effort in Illinois. According to the Chicago Sun Times,

Obama Passed IL Mental Health Parity Law; Members Of Both Parties Sponsored The Bill. Obama co-sponsored and voted for mental health parity bill that requires coverage for serious mental illnesses to be provided on the same terms and conditions as are applicable to other illnesses and diseases. [92nd GA; SB 1341; 4/5/01, 3R P 51-0-6; Signed into law 7/27/01, PA 92-0185]

From his website:

“Under the Obama plan, private insurance offered by employers and both the private and public insurance plans will include coverage of all essential medical services, including mental health care. Obama is a strong supporter of mental health parity and he believes that serious mental illnesses must be covered on the same terms and conditions as are applicable to physical illnesses and diseases. He does not think health insurance companies should be allowed to discriminate against the mentally ill.”

As for Biden, he was a cosponsor of the Wellstone act and has this to say:

Even though mental disorders are widespread in the population, mental disorders and people suffering from them face great stigmatism and discrimination. We must work to reduce the stigma attached to mental illness and to create opportunities for people to seek help and treatment for their illness. I believe in investing in research for new methods of prevention and treatment, and working to make sure these innovations are available to patients by guaranteeing that insurance providers must provide full parity for outpatient mental health treatment. I was a co-sponsor of the Paul Wellstone Mental Health Equitable Treatment Act and I remain committed to the goals of the act as a cosponsor of the Mental Health Parity Act of 2007 in this Congress. In addition, I have fought to make sure that Medicare patients pay the same co-payments and deductibles for a mental health issue as they would for a physical injury.

He further promised (at that time running for president) that he would promote mental health parity through new legislation.

McCain has voted against mental health parity and, in his health care “plan” on his website makes no mention of mental health as an issue. I haven’t been able to find anything on Palin–no surprise there…

In a statement made in response to a questionnaire from the National Alliance for Mental Health (the questionnaire was unanswered, McCain’s campaign said this:

The next President will face a great challenge due to the rising cost of health care of all types. America has the finest doctors and medical science, and the treatment of mental health has shared in these advances. However, as with other aspects of our health care system, spending on mental and behavioral health treatments is rising rapidly. The challenge is to ensure high quality care, establish incentives to control the growth of costs, and thereby permit greater affordable choices.

Mental health is a necessary complement to physical health in all aspects of our daily lives. Fortunately, the path to greater quality and lower costs is to recognize this fact and where possible provide incentives to treat physical and behavioral health together. Chronic disease is a dominant component of the growth in spending on health care and many of our citizens with chronic illnesses have a behavioral health problem as well. For example, untreated depression raises dramatically the cost of treating the physical ailments of a diabetic. A sensible goal is to design reimbursement for taking care of the whole patient, whatever ails them, and recognize the essential role mental health treatment plays in the overall health of the patient and the reduction in physical health needs. Health care at home is important too, they need to feel like they have that support wherever they are, putting them onto home care essentials can be beneficial to them and their health journey, physically and mentally. Some have said that an ionic foot bath detox has helped clear toxins from their body and gain clarity in their everyday life, it may be worth people discussing this option with their doctor.

I have stressed the central role of personal responsibility in leading to lower health care costs. Personal fitness and better lifestyles, especially reduction in addictions of all types – food, narcotics, or cigarettes – can yield dramatic improvements in the cost of chronic illness and high?cost medical care. We can do a better job of treating addictions, but we also have an obligation to do a better job of teaching our children the benefits of good lifestyles and the perils of addictive activities.

I have a strong record fighting for the needs of America’s most vulnerable including those seeking better mental health. I have consistently supported public housing programs that play a significant role in helping meet the housing needs of many seriously mentally ill Americans, and have been a leader in the effort to eradicate homelessness among our Nation’s veterans – many of whom are fighting mental illness. I believe America needs strong leadership and a commitment to bold solutions to address the challenges that it faces. We can provide quality mental health that is more responsive to our needs and is delivered to more people at lower cost.

Most of this is bullshit when dealing with mental health issues. The choice is very clear if one cares about this issue.