Thursday, March 6, 2008

Equal Medical Coverage For Those with Mental Illnesses

After attempts having been made through the past ten years, the House of Representatives yesterday passed a bill which would in effect prevent insurance carriers from discriminating against mental illness patients in setting higher premiums than those for people with physical infirmities. In a 268-148 vote, the House passed the bill that would require insurance companies to provide services to those with mental illnesses comparable to those with physical illnesses. Previously, the Senate has passed a similar bill, but it appears that the President may oppose the current language of the bill as being overbroad.

Currently, insurance providers have no regulations prohibiting them from discriminating between the two types of maladies. Many of these providers set higher co-payment requirements for those seeking assistance with mental health issues; other insurance providers limit the services, including limits as to how many visits may be made to the patient’s doctor, they will cover. Should this bill be approved by the President, health plans for small businesses with fifty or fewer employees and private health plans would still have the ability to discriminate in these ways.

According to the New York Times article reporting this development, there are three primary reasons that there has been a push for increased coverage for those with mental illness. One reason for such a push is that researchers have found some mental illnesses to be genetically linked and have discovered methods of treatment for these diseases. Another factor leading to this push is the fact that there are now insurance companies which specifically deal with the issue of mental illness, providing such coverage at reasonable rates to employers. Finally, with soldiers returning from Iraq and Afghanistan with mental disorders, the stigma associated with mental disease is not as prevalent as it has been in the past.

Those who support these measures view the availability of equal coverage as a civil rights issue. The article lists a few Senators and Representatives who are personally involved with the issue of mental illness, either their own or a family member’s, which presumably led to their support for such legislation.

Those who oppose the legislation claim that the language is overbroad as it covers too many illnesses. The bill would require that any company providing insurance coverage must provide coverage for any mental illness described in the law; for some, this could mean a decision between providing no coverage at all or covering all mental and substance abuse disorders listed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders.

There is a definite need to ensure that those with mental illnesses are provided reliable and effective care. Mental illness can be just as serious, in more cases more serious, than physical illness. Those with untreated mental illness, in some cases, can become a danger to themselves and those around them. With the available treatment for such people, it is necessary to diagnose and provide the proper medicine.

While the legislation passed by the House and Senate is to be commended, it does seem that the coverage is overbroad. To require treatment for every mental illness covered in the Diagnostic and Statistical Manual of Mental Disorders is very burdensome for many employers. Instead of increasing coverage by employers, the business may decide, as is their right, to not offer any coverage at all denying provision of company sponsored insurance for not only mental, but also physical, illnesses. Due to this concern, I believe that the government is on the right track in addressing the issue of medical coverage for those with mental illnesses; however, I believe that more of a middle ground needs to be reached in order to effectuate the goals of any such legislation.

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