By Richard E. Vatz and Jeffrey A. Schaler|October 23, 2008
Psychiatric self-interest groups have tried for years to force insurance companies to cover the treatment of mental illness and addiction. Treating depression as well as disturbing and sometimes simple problems in living on the same level as cancer, heart disease and diabetes is the essence of what has come to be known as "parity."
Now, through political legerdemain, this government-mandated coverage has just become law as an amendment attached to the Emergency Economic Stabilization Act of 2008.
The parity amendment requires that mental health and substance use disorder benefits be "no more restrictive than the predominant financial requirements applied to substantially all medical and surgical benefits covered" by an insurance group health plan or coverage (if said plan covers mental illness). That has a reasonable sound to it. Unfortunately, though, this legislation, unless reversed - or at least modified to apply only to severe disorders - is likely to open up a Pandora's box for the American health care system.
Quietly slipping the parity requirement into the financial bailout bill legislatively resolves a half-century of contentious debate over the definition of "mental illness," whether "psychiatric disorders" are medical disorders, and the nature of addiction. What it does not resolve are the many valid objections to the whole concept of parity - objections that have never been satisfactorily answered.
The issue of coverage for mental illness, on the rise since the 1970s, became a nationally prominent concern largely through lobbying efforts by Tipper Gore, wife of former Vice President Al Gore. Her political activism, revealingly, was first motivated by her situational depression following her young son's serious injury in an accident. Does anyone really believe such upset is an indication of "illness?"
Through Mrs. Gore's encouragement, President Bill Clinton ordered federal parity coverage for psychiatric "illness," though mental illness and addiction were never adequately defined.
There are other problems with the parity argument. Consider:
* The American Psychiatric Association claims that more than 50 percent of Americans are now or will at some point be mentally ill. This estimate, a major increase from years ago, is virtually unlimited since there is no way to accurately confirm or disconfirm "mental illness."
