PSYCHIATRISTS CALL FOR EQUAL COVERAGE

Parity Legislation Would Require All Insurers To Treat Mentally Ill
Same As Other Patients

HUNTINGTON -- Dr. Daniel Cowell remembers a time not too long ago when
people with mental illness were locked in chains and shackles and sent
to state hospitals.

That was back in the late 1950s before new treatments helped get at
the source of mental and behavioral problems; before doctors and
psychiatrists understood how the brain worked; before Paxil, Prozac,
Lithium and other drugs appeared on the market to help restore and
balance chemicals in the brain.

Cowell says treatment has gotten much better since he was a young
psychiatrist. But he says there is still room for improvement. Mainly,
he says the state needs to make sure everyone has equal access mental
health treatment and receives equal coverage under health insurance.

He said the state needs to pass mental health parity, which would
require every insurance carrier to provide the same coverage to mental
health issues as it does other health problems.

"It's morally and ethically wrong to treat a mentally ill citizen
differently than we treat other citizens," said Cowell, professor and
chairman of the Department of Psychiatry and Behavioral Medicine at
Marshall University's Joan C. Edwards School of Medicine.

"We are light years away from where we were 40 or 50 years ago. We
have made incredible developments in treating people with (mental
health) problems. Now, people need to feel as though they have access
to that treatment," he said.

Gov. Bob Wise mentioned mental health parity in his State of the State
address on Jan. 9. That same day, a bill requiring equal coverage for
mental illnesses was introduced in the House of Delegates. A similar
bill was introduced Jan. 15 in the state Senate. Both bills currently
sit in their chamber's banking and finance committees.

According to the National Mental Health Association, 32 states have
some kind of parity. Four states -- Connecticut, Maryland, Minnesota
and Vermont -- offer comprehensive parity that provides full coverage
to all mental health and substance abuse disorders. Four other states
- -- Rhode Island, Indiana, New Mexico and Kentucky -- offer coverage
with some exceptions.

Twenty-four states -- including Virginia, North Carolina and South
Carolina -- have laws that require equal coverage only to select
groups, such as people with several mental illnesses or state and city
employees.

The bill proposed in the West Virginia Legislature would offer full
parity for serious mental illnesses, including schizophrenia,
manic-depression, depression, anxiety, eating and behavior disorders.
It also covers substance abuse treatment.

Some people and organizations oppose the parity bill because they
worry it will cost too much and that employers, both small and large,
won't be able to afford it. They also worry the state won't be able to
afford it.

In addition, many people wonder if the state is overstepping its
role.

"We question whether government should be telling employers who
voluntarily provide coverage to their employees that it's not good
enough and they have to add more," said Steve Roberts, president of
the West Virginia Chamber of Commerce. "We haven't gotten to the point
of saying we oppose this bill, but we are very concerned about it."

Roberts said he would rather see the state focus on trying to get more
companies to provide basic insurance to their workers than dictate
that those who do offer insurance provide more.

"The biggest health care problem in West Virginia is that too few
people have health insurance at all," he said. "If we could fix that,
it would help everyone."

Roberts said passage of the mental health parity bill could be
particularly difficult on small companies who already have high
insurance costs.

"They are already trying to assess what their costs will be," he
said.

The West Virginia bill provides for a 2-percent increase in costs.
However, Insurance Commissioner Jane Cline said most states that have
already approved parity have not seen their costs increase that much.

"It really doesn't cost as much as you'd think," she
said.

Seven major studies have been conducted by different organizations
about how much parity would cost, Cowell said.

The Substance Abuse Mental Health Services Administration reported
that mental health and substance abuse parity would increase insurance
premiums between 3 or 4 percent. In systems that are already using
managed care, implementing parity results in a less than 1-percent
increase in health care costs, according to the National Mental Health
Association.

"The impact on parity is not as great as people fear," said Bob
Hansen, executive director of Prestera Mental Health Services Inc.
"There is fear insurance premiums are going to go up. I think there
are studies that have shown parity laws have passed and that had not
been the case."

About 22 percent of the U.S. population per year suffers from mental
illness or substance abuse, Cowell said. Like other illnesses, early
diagnosis and early treatment is key, Cowell said. Without treatment,
mental illnesses not only harm individuals, but cost businesses
billions of dollars in absenteeism and lost productivity.

Depression ranks among the top three workplace problems, according to
the National Mental Health Association. Clinical depression costs the
U.S. $43.7 billion annually, including workplace costs for absenteeism
and lost productivity, direct costs for treatment and rehabilitation
and lost earnings because of depression-induced suicides.

"It's costing business and others a tremendous amount of money not to
have treatment for these disorders," Cowell said. "It economically
makes sense to achieve parity."

Scott Stamm, CEO at River Park Hospital in Huntington, said if people
had health care benefits to address mental health needs earlier, it
would alleviate the need for hospitals such as River Park. In his
opinion, behavioral health should be part of family medicine, he said.

"I think it's high time people recognize behavioral health care is
just as important as any other specialty," Stamm said. "I'm very happy
to see mental health is going to be put on the same level with other
health care needs."

Delegate Don Perdue, D-Wayne, a pharmacist and one of the sponsors of
the House bill, said now is the time for the state to address parity
and make sure everyone has equal coverage.

"If we keep looking away from mental health, it will be forced on us
and it will be forced on us at an extremely high cost," he said.

"We need to recognize that the only difference between physical
illness and mental illness is the first word. The root is that they
are both illnesses and we need to treat them the same. Until it gets
to the point where we recognize that with our purse as well as our
hearts, we won't see any significant improvements in coverage."