Mental Health Parity Opponents Make Their Case in US Congress

Mental Health Parity Opponents Make Their Case in US CongressBy Julie Rovner WASHINGTON (Reuters Health) Sept 17 - Even as key members of the US Congress continue negotiations with the Bush administration over how to guarantee parity between insurance benefits for mental illness and those for other ailments, opponents of the leading bill in Congress argued on Tuesday that its enactment would be a mistake. With health costs already rising at double-digit rates, "to add mandates to the current third-party payment system is just going to cause it to collapse," said Rep. Jim DeMint, R-S.C., at a forum sponsored by the National Center for Policy Analysis (NCPA). "So anyone who's arguing for mandates at this point is really arguing for single-payer," he said, assuming the government would take over the health insurance system if it truly fell apart. DeMint agreed that it is unfair that patients with mental illness are frequently offered lower benefits than those with other ailments, but he said a better way to address the problem is to move to a "consumer-driven" system, in which patients are given money to spend on healthcare and decide themselves how to allocate it. "That would be better coverage" for mental health, he said. In agreement was NCPA President John Goodman, one of the earliest proponents of Medical Savings Accounts and other ways to make individuals more responsible for their own healthcare. "Patients are the best monitors of their care, they should control the money," he said. Paul Dennett of the American Benefits Council said that in addition to the cost problems, the bill sponsored by Sens. Pete Domenici, R-N.M., and Paul Wellstone, D-Minn., is too ambiguous. While it purports to bar plans that offer different visit limits or copayments for mental health services than for other services, he said, most plans have visit limits for other types of care, such as physical or occupational therapy. And virtually every plan has different levels of cost-sharing, such as for doctor visits, emergency room care, and prescription drugs, he said, making it unclear which levels mental health benefits should match. Dr. Sally Satel, a psychiatrist representing the American Enterprise Institute, questioned the bill's requirement for coverage of all mental disorders, rather than just the most serious ones. "It makes some sense to hold some diagnoses to a different standard," she said, adding that the potential cost "of people with mental health problems rather than mental illness seeking unrestricted care is not trivial." But Dr. Henry Harbin, Chairman of Magellan Health Services, the nation's largest managed mental health firm, said the vast majority of claims his firm handles--85%--are already for the more serious mental disorders. Dr. Harbin said that the cost of a parity requirement is hardly prohibitive. While several states have passed similar laws over the past several years, he said, "at Magellan we have yet to see a cost increase of greater than 1% as a result of a state parity law."