Equal coverage for all diseases

March 12, 1993

The human brain is an organ like the heart, kidneys, lungs or stomach, yet when it comes to medical insurance, an illness of the brain is treated differently from an infirmity of any other part of the body. This discrimination is not right, and should be corrected.

The General Assembly has before it two bills that would end this discrimination. Last year a similar bill passed the Senate but died in the House.

Since the late 1970s, virtually all of the nation's insurance companies have drastically reduced coverage for mental illness. They have imposed spending ceilings on treatment and increased the amount of the patient's co-payment to as much as 60 percent.

As a result, people suffering from mental illnesses sometimes do not receive sufficient treatment or must stretch their financial resources -- and the resources of their families -- to pay for treatment out of their own pockets.

Research indicates that physical and chemical problems within the brain can lead to such illnesses as depression and schizophrenia. The public perception is that mental illness is simply something people can "snap out of." While the mentally ill individual may exhibit bizarre behavior, that person has no more control over his or her illness than does a patient suffering from diabetes.

Insurance companies convinced legislators that non-discriminatory coverage of mental illness would increase their costs and result in higher premiums. The state insurance division estimates Maryland employers and workers would have to pay an additional $5 million in premiums to cover mental illness.

Last year about $2.5 billion in insurance premiums were collected in Maryland, meaning non-discriminatory coverage would raise premiums less than .002 percent. A 1990 Johns Hopkins study estimates that all treatments of mental illness were responsible for between 8.5 and 8.9 percent of total health care costs.

There certainly has been abuse of existing mental health coverage. In too many cases, the amount of treatment conveniently expands to match the amount of coverage a person has. Those abuses can and should be eliminated through strong utilization reviews -- the same as with other treatments.

The bills pending before the General Assembly should be passed so that the mentally ill receive the same insurance coverage as any other ill person. Proper medical treatment would also enable more mentally ill people to recover so they could lead stable and productive lives.

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