Archive for Sunday, January 28, 2001

Health care fairness

January 28, 2001


Mental health is no less important than physical health. Insurance companies should be required to cover treatments for both.

It has taken our society many years to recognize mental illness as a condition that is both unavoidable and treatable, just like physical illnesses.

But we apparently haven't come far enough in acknowledging that fact to require health insurance companies to equalize coverage for mental and physical illnesses.

Last week, the Kansas House Insurance Committee again delayed action on a mental health parity measure that would have required insurance companies to cover mental illness in the same way they do physical illness. The reason committee members gave was that they needed a fuller analysis of the costs of equalizing that coverage.

According to proponents of mental health parity, however, state officials already have a pretty good idea what those costs would be. Just after the House committee rejected its mental health parity bill, the Senate Committee on Financial Institutions and Insurance, chaired by Sen. Sandy Praeger, R-Lawrence, introduced similar legislation.

According to Praeger, the state's employee health plan already covers mental illnesses and has generated base data on what costs would be. Providing mental health coverage in a managed care format for state employees has added about 1.5 percent to the cost of that coverage, Praeger said. That figure is probably on the high end of what the proposal would cost insurance companies, she added, because the coverage in the state employees' health plan exceeds what would be required by the Senate committee's legislation.

As Praeger said following the House committee's action to stall the legislation, mental health parity really is a fairness issue. "The question here is one of fairness," she said. "Is mental illness an illness or not?"

That clearly is the issue, but its significance apparently is lost on legislators who want to delay or reject mental health parity. Rep. Robert Tomlinson, R-Roeland Park, who chairs the House Insurance Committee, told committee members that he has a son with an "autistic-like disorder" and a son with a "chronic heart defect." He said it would be unconscionable for him to support additional coverage for a child with autism if it made it more expensive to obtain insurance for a child with a heart defect.

"What would I say to a parent who had to drop that coverage because they couldn't afford it?" he asked.

The question is: What would he say to the parents of an autistic child who couldn't obtain any insurance coverage at all to help their child? Is it any more acceptable to deny health coverage and treatment for a child or adult with a mental illness than to deny that treatment to someone with a physical illness?

Like physical illnesses, mental illnesses carry a cost not only for individuals but for society. With treatment, many adults with mental illnesses may be able to hold down jobs and become less dependent on state resources. From a pragmatic as well as a fairness perspective, it's good policy for the state to require parity for mental health coverage.

Many insurance plans already provide mental health coverage. The plan being forwarded by the Senate committee is a conservative approach that would allow people three visits for evaluation then place them under the supervision of a managed care system. Both care and costs would be controlled.

One of the main goals of Bert Nash Community Mental Health Center's 50th anniversary celebration is to bring mental illness fully out of the closet and recognize mental health as a goal that is as desirable and achievable as physical health. Equalizing insurance coverage for mental illness is a key step toward that goal. It's time for the state to take that step.

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