- The Washington Times - Monday, April 29, 2002

In a misguided effort to advance his agenda of "compassionate conservatism," President Bush may be on the verge of agreeing to legislation which would strip workers of their ability to make the best health-care choices for their families. When he travels today to Albuquerque, N.M., Mr. Bush is expected to announce his support for an atrocious bill, sponsored by Sens. Pete Domenici, New Mexico Republican, and Paul Wellstone, a very liberal Minnesota Democrat embroiled in a tough re-election fight, known as the Mental Health Parity Act (MHPA). The MHPA, also known as Domenici-Wellstone II, passed the Senate last year. It would outlaw all "disparities" between coverage of physical and mental health problems in group health plans sponsored by companies with more than 50 workers.
Domenici-Wellstone II is an effort to "correct" problems created by the Mental Health Policy Act of 1996 (Domenici-Wellstone I), rammed through Congress by the Clinton administration and Republicans who were determined not to be out-demagogued by the Clintonistas. Domenici-Wellstone I barred health plans from imposing lifetime limits on mental health benefits unless they were also imposed on treatment of physical illnesses. But it permitted plans to place other restrictions on mental health benefits, such as higher deductibles and premiums. The House of Representatives last year voted to extend the MHPA, which was to have expired on September 30. Domenici-Wellstone II went further, by prohibiting health plans from imposing higher deductibles or co-payments for mental health services. It died in conference last year, but lawmakers like Reps. Pete Stark, California Democrat, and Robert Ehrlich, Maryland Republican, are listed among the co-sponsors intent on reviving it this year.
In truth, the overwhelming majority of employees with employer-based health insurance have access to mental health coverage. According to one recent survey, 91 percent of small companies (between 10 and 499 employees) and 99 percent of large ones offer mental health and substance abuse coverage in their most highly utilized medical plans. But that isn't enough for Messrs. Wellstone and Domenici and their allies, who demand that mental and physical illnesses be treated in an identical manner for purposes of insurance coverage. This ignores the fact that different workers have different needs. Employers do not have unlimited amounts of money to spend on health care, and hard choices need to be made. Some workers, for example, may prefer that their health plan spend more money on preventing or treating breast or prostate cancer or heart disease or ensuring that babies get their measles vaccinations. Perish the thought, but some of these things may be more important to some families than drug-abuse treatment, Alcoholics Anonymous meetings or treatment for manic depression.
The bottom line is that individual families, in consultation with employers, should be making these decisions, not political commissars in Washington. Mr. Bush seems to be confusing real compassion with the nanny-statist mentality embodied in Domenici-Wellstone II.

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