People with Mental Health Problems Need Care, Too

Read a summary of the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424) and you quickly understand how messy and complicated democracy and compromise can be.

The act, passed by the House of Representatives in March, will “end discrimination against patients seeking treatment for mental illnesses,” according to the Web site of Speaker of the House, Nancy Pelosi. The bill amends various federal legislation and codes “to eliminate discriminatory provisions that erect obstacles to accessing care for Americans with mental health and addiction disorders.”

It’s all a bit wordy (you should see the stuff I left out), but on the whole, it’s an idea whose time has come. Treat mental illness on the same plane as physical illness and people will get the care they need.

Well, not so fast. Here’s some of the equity act’s fine print, much edited:
• The bill applies only to health plans that already provide mental health benefits (many don’t).
• It prohibits insurance plans from imposing limitations greater than the ones they impose on medical and surgical services. (Sounds good, but limitations are growing every year.)
• It exempts businesses with less than 50 employees and those that experience certain increases in health insurance premiums in subsequent years. (What business has not experienced an increase in premiums?)

The Senate passed their version of a mental health parity bill in September, so now it’s up to the two branches of the legislature to work out something that will make everyone happy—or mostly everyone. Unfortunately, that means that provisions will be pretty watered down.

I haven’t seen the Senate’s version, but the House’s version looks like something that allows congressmen and congresswomen to tell The People that they addressed the problem and came up with a solution. In actuality, the result is likely to accomplish little. All the exemptions mean that, in the end, not many health plans are going to do much more than they do now, which is not much.

Oh, one more thing. Members of the House and Senate, as well as the other 8.5 million people who work for the federal government, have health insurance that pretty well covers treatment for mental health care.

Do you think mental health care should be covered more fully than most policies now offer?

Do you think mental health care should be a part of universal health insurance?

Is the answer to purchase mental health benefits separately and voluntarily, as some health plans are structured?

Tell us what you think.