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Untreated Mental Illness Costs State a Bundle

By Kathryn Burns

Before state legislators cast their votes on the Mental Health Insurance Equal Treatment Act, they'd be prudent to consider that neglect in treating mental illnesses costs Ohio more than $2.5 billion annually. The Mental Health Insurance Equal Treatment Act, HB 225, proposed by Rep. Lynn Olman, would bring parity to mental-health insurance. Ohio is one of only 15 states that have not passed some form of parity law requiring private insurance to cover mental illnesses the same as other illnesses.

It's time that Ohio acknowledges that mental illness is a condition that responds to treatment and should be covered fairly by insurance.

At issue are the more than 250,000 Ohioans treated in the public mental-health system. In Cuyahoga County alone, one in five people have a mental illness, and more than 90 percent go untreated. Many people go untreated because they do not qualify for Medicaid and do not have enough money to cover the cost of treatment on their own when their insurance policies don't cover the services they need. Mental-health disorders are among the most prevalent and neglected health problems in our nation. Mental illness is the second leading cause of disability and premature mortality. Depression affects more than 19 million Americans.

Furthermore, workers with under-treated mental illnesses add millions annually to employee absenteeism, turnover and retraining expenses, lower productivity and medical costs. Clinical depression alone costs the United States $24 billion in workplace costs.

Yet, there are tremendous disparities between mental and physical health-care coverage. Health plans can arbitrarily limit the number of doctors visits for mental disorders and require higher co-payments than they do for physical problems.

Our health-care system even discriminates between disorders of the brain. The brain disorder Parkinson's Disease is caused by too little production of the neurotransmitter dopamine. Schizophrenia is caused, on the other hand, by over-active production of dopamine. Basic health-care insurance covers standard treatments for Parkinson's. Increased co-pays and other limits on benefits are placed on those who suffer from schizophrenia. Treatment works. Major depression can be treated successfully in 65 to 80 percent of the cases, depending on the level of treatment. Panic disorder is a major reason for visits to hospital emergency rooms. Between 70 and 90 percent of these cases can be treated with medications and therapy. By comparison, the overall success rate of some commonly used treatments for heart disease is only 45 to 50 percent.

Mental health parity has broad-based bipartisan support, including the backing of President George W. Bush, probably at least in part because more than 80 percent of Americans believe it's unfair for health insurance companies to limit mental-health benefits and require people to pay much more out-of-pocket for mental-health care than any other medical care. Rep. Olman has supported parity for nine years. Equal access to these services is a sound, rational investment.

The most frequent argument raised against HB 225 is that it's too expensive. Parity, however, is affordable.

State parity laws have had a negligible effect on premiums. In states with full parity for mental health in private health insurance plans, insurance premiums have increased less than one percent. Studies also have shown that health plans that impose the highest financial barriers to mental health services have higher rates than plans with easier access to mental-health services. Minimal cost increases associated with parity would be more than offset by increased productivity of workers, the overall reduction of medical costs, crime, homelessness and the subsequent increase in the number of contributing taxpayers with private insurance.

The Mental Health Advocacy Coalition believes HB 225 strikes an appropriate balance between the concerns of advocates and employers. We encourage state legislators to take an important step to enact meaningful mental-health parity to provide Ohioans with the care they need. People with mental illness deserve a health-care system that treats their illness on the same level as a physical illness.

Burns is the chief clinical officer for the Cuyahoga County Community Mental Health Board.

© 2003 The Plain Dealer. Used with permission.

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© Copyright 2008 State Representative Lynn Olman. All rights reserved.

 

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