Congress is right to press for health-insurance parity
01 04 08 - 13:07
Health-care coverage should mean exactly that — coverage for health care. It should not mean only some kinds of health care.
But in what is an indefensible problem in devising health-care coverage, many plans and employers persist in believing mental health care is somehow not like other health care. And some don't offer mental health coverage on an equal basis with coverage for physical ailments. The distinction does not make sense. There should no more be lines drawn on covering mental health care than to distinguish between covering heart ailments from stomach ailments.
Fortunately, Congress is on the job in attempting to bring mental health-care parity to the fore. Both the Senate and the House have passed versions of mental health-care parity bills. Both require plans that offer mental health benefits to have parity with the benefits covering physical ailments. The better version of the bill is in the House. The bill is named for the late Sen. Paul Wellstone of Minnesota, who was an important voice in Congress on mental health-care issues.
The House version of the bill, sponsored by Rep. Patrick Kennedy, D-R.I., would require that if a mental health-care plan is offered, it must cover disorders listed by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, which is a comprehensive list. The Senate version of the bill would allow insurers more freedom to restrict some ailments from coverage. Coincidentally, the Senate bill, which shares many attributes of the House bill, is sponsored by Sen. Edward Kennedy, D-Mass., father of Rep. Patrick Kennedy.
Opposition to the House legislation has bordered on absurdity. One argument is that by including the ailments listed in the psychiatric manual is that employers would have to cover expensive treatment for conditions as obscure as jet lag. The complaint goes that if insurance has to cover every malady in the book, the only option will be to provide no mental-health coverage at all. No reasonable person could argue that beneficiaries are going to flock to psychiatric help for jet lag and break the bank by doing so.
Another complaint is that the House bill seeks funding by increasing a Medicaid rebate. The Medicaid rebate was created in 1990 requiring drug companies to discount part of their revenues from sales to Medicaid patients. Under this bill, the rebate would move from 15.1 percent to 20.1 percent. Big drug companies say that will result in higher costs for other consumers. Complaints from drug companies are no surprise. They have had their way with Congress for many years, and it does not occur to them that fairer prices are in order. In fact, if costs are part of the issue, that's a call for government to get tougher, not weaker, in the amount of money being shoveled at big drug companies with their fancy lobbyists.
Congress has been down the path of mental health-care parity before, passing a law in 1996 that said if insurance plans had annual or lifetime dollar limits on coverage for physical illnesses, the same level had to apply to mental health benefits. But a report by the Government Accountability Office said employers still put more limits on mental health coverage than on other coverage.
It is tiresome that the nature of mental health care continues to be such a point of double standards and outright discrimination in health coverage. Nevertheless, it is heartening that many members of Congress see the need to bring parity and fairness to what should be an otherwise simple point of need in improving people's health.