If you were diagnosed with a brain tumor, would you seek treatment or would you ignore it and hope it goes away? Would your answer differ according to whether your health insurance covered treatment? A diagnosis such as a brain tumor, or Parkinson’s disease, is a serious matter. Just as serious are the diagnoses of mental illnesses and addictions. But depending on the location of the illness in your body, the decision to seek treatment may be harder to make.
Mental health and addiction patients are discriminated against because employers and insurers often do not classify these disorders as diseases of the brain. Yet we know after decades of brain research that they indeed are diseases, and that effective treatments exist.
As it stands now, health insurers offer coverage and reimbursement if you need cancer therapy or treatment for Parkinson’s disease, heart disease, diabetes or any other physical illness. But if you are diagnosed with a mental illness or need treatment for an addiction, you are likely to face unequal and unfair insurance barriers that can be catastrophic to your health, your financial security and even your life. This is unconscionable. Patients affected by these disorders should be treated with the same urgency and diligence as patients with any other disease, and should receive the same health-care options and coverage.
And lest you think this doesn’t affect very many of us, according to the National Institute of Mental Health, an estimated 26.2 percent of American adults suffer from a diagnosable mental illness (57.5 million Americans in 2004), and 21 percent of children ages nine to 17 suffer from a mental illness or addiction disorder. Yet less than half of individuals who need help are able to receive the appropriate level of care they require (Surgeon General’s Report 2000). According to the federal Substance Abuse and Mental Health Services Administration, 23 million Americans suffer from alcoholism and other drug dependencies, yet only 1.5 percent of teen-agers and adults with these challenges received treatment in the past year for these illnesses.
Approximately 65 percent of Americans have some form of health insurance, but these plans usually impose higher co-pays and deductibles, as well as restrictive annual and lifetime limits on the number of visits and days of treatment covered for addiction and mental illnesses.
Untreated mental illnesses and addiction cost American taxpayers close to $600 billion per year through indirect costs related to unemployment and reduced productivity, and through diverted costs to other areas, such as criminal justice, homeless shelters, foster care, etc. But the personal costs are inestimable if you lose a loved one to suicide because of untreated mental illness or addiction. Almost as many people die from suicide each year as from war and homicides combined. This kind of tragedy can hardly be measured in dollars.
Our country can afford to end this discrimination. The costs to our society for untreated mental illnesses and addiction must compel us to work toward fixing our broken system. A recent report by the research firm Milliman (2007) found that providing coverage for mental health and addiction treatment services in parity with other diseases would cost less than a loaf of bread per person per month (or less than one tank of gas per person per year).
The late Sen. Paul Wellstone, Minnesota Democrat, was a passionate advocate for those with mental illnesses and addiction, and beginning in 1992 he and Sen. Pete Domenici, Arizona Republican, worked tirelessly to pass legislation that would stop insurers from discriminating against people suffering from these illnesses. In 1996 they were partially successful with the passage of the Domenici-Wellstone Mental Health Parity Act. While this was an important first step that did result in the elimination of lifetime and annual dollar limits on the treatment of mental illnesses, 87 percent of complying health plans replaced the dollar limits with limits on inpatient days and outpatient visits or another part of their benefit plan. Until his tragic death in 2002, Mr. Wellstone continued to work with Mr. Domenici in trying to pass stronger legislation.
This week, a House subcommittee chaired by Rep. Rob Andrews, New Jersey Democrat, heard testimony regarding the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424), which ensures that mental health and addiction patients are treated no differently than other medical or surgical patients. The Wellstone Act does not force companies to offer mental health or addiction treatment benefits, but if such benefits are covered, they must be offered in the same manner as other medical and surgical coverage in the plan.
Mr. Wellstone fought long and hard for those who had no voice and he demonstrated a strong personal commitment to those with mental illness and addiction issues. It is our prayer that congressional lawmakers will honor his legacy, and help the millions of Americans suffering from these diseases by passing this bill and sending it to the president.
Betty Ford and Rosalynn Carter are former first ladies.