ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Monday, May 6, 1996 TAG: 9605060093
SECTION: NATIONAL/INTERNATIONAL PAGE: A-4 EDITION: METRO
DATELINE: WASHINGTON, D.C.
SOURCE: Fort Lauderdale Sun-Sentinel
Two years ago, Elliott and Dianne Steele's daughter got so sick she had to be hospitalized.
Then another nightmare kicked in - a nightmare of insurance limits.
Had the Steeles' daughter, then 19, been diagnosed with diabetes, cancer or almost any other illness, their health insurance would have covered her care up to $500,000.
But their daughter's illness is mental. She has schizophrenia.
Her treatment was covered under Elliott Steele's health insurance policy, briefly. She exhausted its lifetime limit of $25,000 for mental illness in less than three weeks. She now relies on Medicaid, the government health insurance for America's poor.
``Ours is just one story,'' said Dianne Steele, of Seminole. ``You could hear 100,000 stories.''
Should health insurers be required to treat mental illnesses the same way they treat other illnesses?
The U.S. Senate recently said yes - as part of an insurance reform bill that once seemed on its way to final passage in Congress.
But now, business groups say the measure would push up the cost of insurance premiums and could force some businesses to drop health coverage for their employees.
Powerful business groups, including the U.S. Chamber of Commerce, the National Association of Wholesaler-Distributors and the National Association of Manufacturers, once supported the Senate health insurance reform bill, passed in late April. The bill's thrust is to guarantee that millions of U.S. workers could still get health insurance if they changed or lost their jobs.
But as House and Senate conference committees prepare to work out the differences between their bills, businesses are lobbying against the Senate version because of an amendment tacked on in the final hours of debate.
The amendment would make insurers cover mental illnesses as extensively as they cover other illnesses.
About 5 million Americans, nearly 3 percent of the population, experience severe mental illness every year, according to the American Psychiatric Association.
Mental health professionals praise the provision as a huge step toward ending discrimination against the mentally ill and getting people the treatment they need. Melvin Sabshin, the medical director of the American Psychiatric Association, called it ``an historic affirmation of fairness'' for the mentally ill.
Businesses call it something else: an unwelcome mandate from the government. If the mental health amendment is enacted into law, ``there will be an endless parade'' of advocates for other services ``knocking at the federal door, asking for mandates that apply to their particular field,'' said Neil Trautwein, manager of health care policy for the U.S. Chamber.
Under the ``parity'' amendment, if insurers offered 120 days of hospitalization for heart disease, for example, they would have to do the same for a mental illness.
Gone would be the days of making people pay steeper insurance co-payments or deductibles for mental health services. Gone would be lower lifetime limits for the treatment of mental illnesses. Currently, for example, a plan can place caps of $1 million for traditional medical care and $50,000 for treatment of mental illness, about enough for a few brief hospital stays.
About 64 percent of people with severe mental disorders - including schizophrenia, manic-depressive illness, major depression, panic disorder and obsessive-compulsive disorder - have private insurance, but the insurance rarely adequately covers their treatment, mental health experts said.
Yet, severe mental illnesses often can be treated effectively, experts said. The National Institute of Mental Health estimates that most treatments have a 60 percent to 80 percent success rate.
Angioplasty, the cardiovascular treatment, has a 41 percent success rate.
Making mental health coverage equivalent to coverage for physical illnesses would mean a $2.2 billion net savings for the nation, according to the National Institute of Mental Health. The savings would come partly because people with mental disorders would use 10 percent fewer general medical services if they got proper treatment for their mental illness, NIMH estimates.
Opponents to parity say they are afraid the cost of treating various mental illnesses would rapidly outpace the already troubling cost of general health care.
Countered Laura Lee Hall, deputy director of policy and research for the National Alliance for the Mentally Ill: ``Business will reject any new imposition by the government to do anything."
LENGTH: Medium: 87 linesby CNB