Pushing Parity

During my 14 years in Congress, I've had the opportunity to meet incredible people and hear amazing stories of triumph, heroism, and bravery. While these remarkable stories may grab a headline in the morning's paper or a brief spot on the evening news, it is the so-called "unremarkable" stories I hear every day that really stay with me -- the stories of people who are fighting for health-insurance coverage.

The inequity that exists within our health-care system is broad and severe. It cuts across geographical borders, income levels, races, and diagnoses. In 2006, an eight-state survey financed by the Substance Abuse and Mental Health Services Administration found that adults with serious mental illnesses served in the public mental-health system die, on average, 25 years earlier than other Americans. By extrapolation, this places the life expectancy of an African American male served in the public mental-health system at age 48. Tragically, this is largely a consequence of the stigma and shame that has guided the development of our laws, segregating mental health from our overall health-care system. As was reported in Mental Health: A Report of the Surgeon General (1999), even our "everyday language tends to encourage a misperception that ?mental health' or ?mental illness' is unrelated to ?physical health' or ?physical illness.' In fact, the two are inseparable."

Barriers enacted by health-insurance companies -- including arbitrary limits on the number of visits to a doctor's office or higher co-payments to see a mental-health professional -- prevent individuals from seeking care for their mental illnesses. Patients must follow the advice of their insurance companies, not their physicians, in order to access care. The statistics are startling, but the stories are devastating. Just this year, I heard about a 16-year-old girl who was actively trying to seek treatment for her addiction to heroin. Her doctor recommended that she immediately receive treatment in an inpatient facility. Her insurance company told her that she was not "sick enough" for inpatient care, but if she overdosed, then she would meet its criteria for the recommended treatment.

Without the treatment she needed, she did, in fact, overdose. And she died.

This is just one of thousands of tragic stories that I carry with me as I fight to pass mental-health parity legislation, to eliminate the discriminatory treatment and financial limits for mental-health and addiction benefits that are more restrictive than other medical benefits. Since 2000, I have worked closely with my colleagues to hold hearings on this issue and to bring this bill to the floor for a vote. Over time and through raised awareness, the basic premise of mental-health parity has received broad support, but this is the first year the bill was granted a full debate before members of Congress. In March, the legislation passed the House with a strong bipartisan vote of 268 to 148. Under the leadership of Speaker Nancy Pelosi and with the tireless efforts of mental-health advocates across the country, I'm proud to say this lifesaving legislation is finally being treated as a priority for all American families.

Last year, my good friend and lead sponsor of parity, Congressman Jim Ramstad, and I traveled across the country, holding informal field hearings on mental health and addiction. We listened to hundreds of Americans who want Congress to help provide greater access to treatment. We heard from consumers and providers, police chiefs and judges, business leaders and insurance executives, hospital presidents and public-health officials. All of them understand that treating people with mental illness and addiction, rather than casting them aside, is crucial to addressing many problems in health care, education, criminal justice, homelessness, veterans' health care, and more.

Additionally, recent studies continue to validate the key rationale behind the legislation; not only is it the right thing to do, it's cost effective. A study funded by the National Institute of Mental Health released in May found that major mental disorders cost our national economy $193 billion in lost earnings alone. Further, when mental-health parity was implemented in the Federal Employees Health Benefits Program, there was little to no cost increase to deliver mental-health benefits that are no more restrictive than other medical benefits.

But all the studies in the world don't begin to address the real issue behind mental-health parity. No American principle is more fundamental than ensuring that all persons have a chance to pursue their God-given potential. But for tens of millions of Americans living with mental illnesses and addiction, the promise of achieving the American dream is elusive, blocked by treatable diseases left untreated.

Ending insurance discrimination is about whether our nation lives up to the ideals of the Declaration of Independence and the Constitution, promising every person an equal opportunity to reach his or her potential. The American dream should not be rationed by diagnosis. Nobody would think of telling cardiac or cancer patients or diabetics that their diseases are just too expensive to cover fully. It would be unconscionable, just as it is to restrict coverage of chronic brain diseases.

Currently, Congress is working with a new sense of urgency to reach agreement on a historic, comprehensive mental-health parity bill that President Bush will sign into law. As that day nears, I am hopeful all Americans will begin to better understand the challenges those with mental illness and addiction face on a daily basis. Only then can we truly begin to erase stigma, save lives, and deliver the promise of the American dream to everyone in our nation.