Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, May 16, 1994 TAG: 9405160042
SECTION: VIRGINIA PAGE: C-1 EDITION: METRO
SOURCE: LAURA WILLIAMSON STAFF WRITER
DATELINE: LENGTH: Long
Another patient, an auto mechanic who suffers from an anxiety disorder and marital difficulties, can't keep up with his co-payments, either. His insurance company wants him to pay half of the cost of $90-per-hour sessions with Rogers. His half of the bill kept mounting, so Rogers gave him a $500 discount.
"Basically, I had to eat it," Rogers said. "I didn't want to drop him, because he needs help."
So do a lot of Virginians. According to the Mental Health Association of Roanoke Valley, about 1 million adults statewide suffer from one or more mental illnesses.
But many of them can't afford their share of the cost of therapy.
In Virginia, insurance companies typically cover 80 percent of the cost of physical health care, but pay only half the cost of mental health services, sometimes with caps of $1,000 to $2,000 per year.
That's not right, Rogers said. It adds to the stigma of mental illness and creates financial difficulties for both patients and providers.
Rogers, president of the Blue Ridge Academy of Clinical Psychologists, joined consumers and providers in forming Roanokers for Mental Health Equity, the local arm of a statewide group pushing for equal coverage of physical and mental health care.
"There's a great deal of discrimination being practiced in Virginia," said state Sen. Edward Houck, D-Spotsylvania, who sponsored a bill this year that would have forced insurance companies to provide the same standard of coverage for mental and physical illnesses.
The bill was referred to the Special Advisory Commission on Mandated Health Insurance Benefits, which will hold a public hearing on its merits today in Richmond. The commission will vote either today or June 13 on whether to recommend the bill's passage to legislators, who will take it up again in committee before Dec. 20.
Diane Kelly intends to be there today to let the commission know what she thinks.
Kelly, executive director of the Mental Health Association of Roanoke Valley, has been pushing for parity since the issue first surfaced in 1992. The association is also a member of Roanokers for Mental Health Equity.
"We don't see any reason to treat mental illness any differently than physical illnesses," she said.
For one thing, it's more expensive not to treat mental illness than to treat it, she said.
According to the Mental Health Association, loss of productivity because of mental illness cost the United States nearly $74 billion in 1988. A study by the Alcohol, Drug Abuse and Mental Health Administration found the indirect costs of mental illness were three times the cost of treatment.
Rogers said patients who can't afford mental health care often go instead to their family physicians, putting an additional strain on the system.
Insurance companies, however, will argue that mandating more coverage of mental health benefits will be expensive.
Roderick Mathews, senior vice president of Blue Cross/Blue Shield We don't see any reason to treat mental illness any differently than physical illnesses. Diane Kelly Mental Health Association of Roanoke Valley of Virginia, said the Blues would take no position on the bill today but would provide information about how much it would cost. He could not supply that information last week.
"Our only concern is that mandated benefits increase the cost of health care," he said.
What's more, he said, mandates have the heaviest impact on individuals and small groups who can least afford an increase in premiums. State and federal employees, as well as larger companies that are self-insured, are typically not affected by mandated coverage because they are either exempt from it or their policies are not written in Virginia. State laws mandating insurance coverage apply only to policies written in Virginia.
That means only about 30 percent of Virginians would be affected.
Neither Kelly nor Houck expects a parity bill to pass this year. It could be several years before such a bill passes, if ever, they say.
Houck said he won't even ask the commission to approve the bill as written. He knows it would never get out of the Senate Committee on Labor and Commerce, which is loaded with legislators sympathetic to business interests. If such a bill passes, the higher cost of health insurance premiums would be passed on to employers.
Instead, he's planning to ask the commission to create a task force of mental health consumers, providers and business leaders who can work out a compromise. He hopes such a task force would move Virginia - perhaps only an inch at a time - toward equity in coverage.
Even if it takes years.
"I think we're all realistic enough to understand that that is what's going to have to happen," Kelly said.
She doesn't mind. As long as they eventually get where they're going.
"Parity is the goal," she said.
by CNB