By Jeanine Long and Pat Thibaudeau
Recently, President George W. Bush voiced his support for mental health parity, recognizing there should be no separation between the treatment and coverage of mental and physical ailments.
"Americans with mental illness… deserve a health-care system that treats their illness with the same urgency as a physical illness," he said.
We’re thankful for the national leadership and support on the mental parity issue, an issue we have been supporting for years.
We have made great strides in our society when it comes to accepting mental illness and taking steps toward treatment. Unfortunately, in many states — including Washington — we still continue to separate mental health from physical health, failing to recognize the two cannot be separated. That’s why we still face the sad statistic that roughly one in five Americans suffer from mental illness but less than half of them ever seek treatment.
It’s time for policy-makers in our country — and in our state — to recognize there is no division between mind and body when it comes to people’s health. There’s no question that a person suffering from a long-term physical ailment with no treatment ends up costing more in the long run, but somehow this logic does not follow when that person suffers from a treatable mental ailment.
If we changed the way we look at this issue to truly recognize the long-term costs of ignoring mental illness, we would have better success in explaining to the public and policy-makers the value of early treatment. This would, in turn, reduce the stigma and help more people become productive employees, students, and members of society.
The National Institute of Mental Health estimates the cost of untreated mental illness at $300 billion a year, including social-welfare and criminal justice. The Coalition for Fairness in Mental Illness Coverage estimates comprehensive community-based mental health services for children and adolescents can cut public hospital admissions and lengths of stay and reduce average days of detention by 40 percent. The Coalition for Insurance Parity reports research advances in the diagnosis and treatment of mental illness enable millions of people to recover quickly and return to productive lives.
Yet, on both the state and national level, mental health coverage is still just an "option" for many insurance plans. Washington law says health insurance carriers that provide group coverage must offer supplemental coverage for mental health treatment. However, this may be waived at the request of the employer.
If the employer chooses to offer mental health coverage, the plan is not required to have deductibles or co-payments equal to those for medical or surgical care — though employers may certainly choose to purchase plans that do.
The federal Mental Health Parity Act of 1996, which President Bush extended through December 2002, also applies to businesses that choose to provide mental health coverage. Similar to Washington state, no one is required to provide a mental health benefit. The federal act differs from the state law in that it requires group plans that offer mental health benefits to ensure annual or lifetime dollar limits on those benefits are no more restrictive than the limits they allow for coverage of physical illnesses.
Mental health parity on the state and national level makes sense, not only from a fairness perspective but also from a financial perspective. For example, the MIT Sloan School of Management reported that in 1995, clinical depression cost American businesses nearly $29 billion in lost productivity and absenteeism.
In contrast, in a 1998 review of a comprehensive mental health parity proposal, the state Department of Health found benefits of parity outweigh the costs and that states that have required parity have found the cost increases to be minimal, in the 1 to 2 percent range in well-managed plans.
Our most recent proposal originally would have required insurance plans to cover inpatient mental health services for a minimum of 15 days and outpatient therapy for a minimum of 30 visits. Co-pays would have had to be on par with other medical and surgical services and a single deductible would have applied for medical, surgical and mental health services. We later narrowed the focus to dependents, or children who are still eligible for coverage under their parents’ insurance, in order to keep costs as low as possible in a tight budget year. However, we continue our commitment to mental health parity in the future.
Clearly, this is a pocketbook issue as well as a "people" issue. From both a common sense and compassionate perspective, mental health parity makes sense.
Sen. Jeanine Long, R-Mill Creek, is ranking Republican on the Senate Human Services and Corrections Committee. Sen. Pat Thibaudeau, D-Seattle, is chair of the Senate Health and Long-Term Care Committee.