Rep's Corner

When the film “A Beautiful Mind” took the top honor at this year’s Academy Awards celebration, critics’ circles and media types alike rightfully praised the work of director Ron Howard as well as the performances of those portraying John and Alicia Nash for adapting the pair’s truly remarkable lives to the big screen.

Much more subtle, yet equally significant, was the film’s successful depiction of schizophrenia’s devastating effects. The film is presented through the eyes of Nash, and the audience is led to believe, as does he, in the reality of certain characters and situations. Right up until the revelation of Nash’s illness, the viewers find themselves identifying with Nash, questioning the motives of those claiming to “help” him and trusting that his amazing skills of rational thought and methodology will persevere and lead him to discern friend from foe.

For 134 minutes, “A Beautiful Mind” allows the viewer to take a vicarious ride on the nightmare that is schizophrenia. Though the film experience culminates after roughly 2 ¼ hours for most people, it is far more lasting for the 2.2 million Americans actually suffering from this brain disorder. An estimated 2.8% of Ohioans suffer from schizophrenia and other serious mental illnesses, which translates to over 300,000 citizens.

Mental illness knows no gender, race, or socioeconomic boundaries. Abraham Lincoln, Winston Churchill, Ludwig von Beethoven, Ernest Hemingway, Sir Isaac Newton, and Patty Duke are just a few of the famous figures that have suffered from mental illness.

John Nash’s “recovery” stemmed largely from his eventual embracement and acknowledgment of his vulnerability, as well as the patience, love and treatment he received from his wife, colleagues and medical community. Many in our own state should be so fortunate.

The fact is our state and local mental health systems often work wonders, but their services are not always guaranteed. Local services are heavily reliant upon the passage of ballot levies and public support, which can be fickle, especially in poorer rural and urban areas that do not enjoy a favorable tax base.

At the state level, it’s not much prettier. As we have seen, during dismal economic times state budgets are often trimmed to the bone. Although the General Assembly protected mental health funding during this latest budget crunch, it remains woefully inadequate. Simply put, state funding for the treatment of mental illness has not kept pace with inflation and rising health care costs over the past decade, while demand has steadily risen.

What about those fortunate enough to receive care through a private insurance plan? More often than not, people suffering from debilitating mental illness and substance abuse are told that their visits are limited, that their treatments must come to an end. Worse yet, the same patients are asked to come up with co-payments and deductibles vastly unequal to those charged for routine physical ailments.

This brings us, my friends, to House bill 33. HB 33 marks my third legislative attempt to achieve equal treatment (a.k.a. “parity”) for those who suffer from mental illness. HB 33 is not a cure-all. It is not the panacea to eliminate mental illness and addiction in this state. What it represents, however, is the step in the right direction. The goal of HB 33 is simple: it requires health insurance policies to cover treatment for mental illness and addiction the same as it would for other health services. It ensures that those who already have health insurance are given proper access to the necessary treatment should they or their dependents become stricken with mental illness. This way, people who are already working, purchasing health insurance, and leading independent lives as productive taxpayers can properly deal with mental illness without missing a beat.

Thirty-three other states in the U.S. have enacted some form of equal treatment legislation to remedy the situation. Some states have done much to help, others have done minimal--all thirty-three, however, have done more than Ohio. Why have we failed to address this issue?

Lack of effort cannot be blamed. HB 33 marks the fourth consecutive piece of legislation to tackle this problem. Incidentally, a commissioned study just last year outlined twenty-six recommendations for the Ohio Department of Mental Health. The report outlined the needs of Ohioans with mental illness, and provided a comprehensive plan of action for prevention and early intervention. Recommendation number three on this report was as following: “Ohio should pass a strong and comprehensive parity law for mental health coverage that extends those benefits now provided for state employees and their dependents to all people in state-regulated insurance plans.”

With such a blatant need for improvement, why still would our state leaders hesitate? The underlying answer to the state’s inactivity is simple. The business community and insurance industry will not allow this issue to come to fruition.

Opponents of this legislation claim that any increase in the quality of health care involves a corresponding increase in the costs of insurance. They worry that when the government forces, or “mandates” the cost of insurance to increase, businesses will decide it’s too expensive and quit purchasing it altogether for their employees--thus driving up the number of uninsured.

In reality, nothing could be further from the truth. Data from the U.S. Census Bureau indicates that from 1995-1999, the percentage of Ohioans without health insurance actually decreased while the costs of insurance premiums continued to go up. In the year 2000, the percentage of those without health insurance was 10.8%, while the number was 11.9% in 1995. In fact, over the past ten years the percentage of uninsured in Ohio has held steady between 10-12%. Conversely, health insurance premiums have continued to rise considerably every single year.

The misconception that equal treatment is not affordable likewise does not hold water. TO gauge the costs of HB 33, the Ohio Legislative Service Commission called for an unbiased, independent study to be performed. The study concluded that implementation of mental health parity would result in an average change of only 1% to 1.5% in health insurance premiums. Furthermore, it indicated that these increases would actually be less with managed-care controls.

For those opponents worried about costs to businesses, the dollar amount that they are continuing to overlook is $5.5 billion. This is the annual combined cost of mental illness and addiction to the citizens and businesses of Ohio. While $2.5 billion of that relates to direct treatment costs, the remaining $3 billion is the indirect cost of not treating mental illness and addiction. These costs, such as disability, lost productivity and worker absenteeism, businesses must shoulder.

Another core argument against HB 33 is the classic case of businesses simply not wanting to be told what to do by the government. The free marketplace, they contended , will dictate what should and should not be covered under health insurance policies. If workers really want this type of coverage, then they will simply demand it from their employers.

There’s just one small problem with that argument. It’s easier said than done. People can’t just simply demand adequate mental health and addiction coverage. Schizophrenics don’t wear their illnesses proudly on their sleeves. Telling your boss you’re bipolar or that you suffer from major depression and need better coverage doesn’t quite have a favorable ring to it.

People may not want to admit it, but there is a definite stigma against mental illness in today’s society. Miss a day of work because of the flu, and nobody raises an eyebrow. Miss a day of work to combat severe depression, and your work ethic is suddenly questioned in discussions at the water cooler. That’s because mental illness is difficult to grasp. Those who suffer look normal, and typically walk and talk no differently that anyone else. There are no visible physical deformities or abnormalities that would normally raise a red flag signaling disease, and some mental illnesses manifest at different stages in a person’s life.

Insuring proper access to treatment for mental illness and addiction through HB 33 acknowledges the physical nature of these illnesses, and affords the dignity and privacy of treating such to patients in the same way as patients being treated for other personal physical ailments.

The battle for equal treatment in Ohio has always been and still remains an uphill one. Support for this legislation is the highest it’s ever been. There are thirty-four legislators with their names on this bill, with three more yet to be added and still others willing to vote in favor.

People should not have to hit rock bottom, lose their jobs and deplete their finances before turning to public assistance in order to finally receive proper treatment for mental illness. Unfortunately, this is the status quo. The unwillingness to pass three versions of this measure coupled with the stubbornness displayed by the insurance and business community demonstrates complacency with the status quo.

One of the fundamental goals of House Bill 33 has always been to reduce the reliance upon our public assistance programs. As a legislator, I believe that we have a fiduciary duty to Ohio taxpayers to reduce overall dependence upon government social programs when possible. However, the discrimination that currently exists within the private health care insurance system allows those with mental illness to prematurely exhaust their available benefits. Once this happens, those affected are unable to maintain steady employment and productivity and must now resort to taxpayer-funded relief.

It is a fact that with proper diagnosis, care, and treatment, many Ohioans who suffer the crippling effects of mental illness can lead independent, productive lives as taxpaying citizens. The recovery rates themselves prove the effectiveness of treatment. Success rates include the following: Schizophrenia, 60%, bipolar disorder, 80%, major depression, 65% to 80%, and addiction treatment, 70%. These rates surpass treatment success rates for other physical illnesses like heart disease, which can range from 41% to 52%. Additionally, the introduction of managed-care into private health plans would both guarantee more efficiency and prevent abuse of coverage better than those programs supervised by government.

Another obstacle that parity legislation will continue to face is our current system of term limits. The evolution of our state legislature towards finite tenures has resulted in an increased urgency to establish immediate credibility and cohesion with Ohio’s business community. This year’s election cycle promises much of the same as freshmen legislators and new candidates alike vie for the important endorsements of both the business and insurance lobbies.

This does not necessarily spell the end of the fight for mental health parity. If history has taught us anything, it’s that persistence eventually brings about action. The concealed carry movement and its result as of late is a strong example of such.

Those who wish to make their voices heard may contact my office at (614) 466-1731 and are urged to call or write Governor Taft and the offices of House and Senate leadership. They should also contact their local Chambers of Commerce and urge them to work on resolving this issue, which has been ignored for too long in the workplace. I further encourage those interested in becoming involved with issues like these to visit the website of the Ohio branch of the National Alliance for the Mentally Ill (NAMI-Ohio) at www.namiohio.org.

While the dialogue generated by the film “A Beautiful Mind” has already begun to change the perceptions of mental illness, the time has come for our state to act with sound public policy for so many “beautiful minds” already living amongst us.


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