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Commentary


Americans Need Health Care Choice

March 7, 2008
By Pete Sepp

Mental health care has improved countless lives, including those of at least six people I know. So why would I question pending legislation forcing insurers to provide the same level of coverage for these conditions as they do for other ailments?

Because Washington can do better.

Thankfully, mental health is a national priority. According to federal statistics, 90 percent of private industry workers with health insurance plans are covered by outpatient mental care benefits -- more than those who can avail themselves of well-baby care or adult immunizations.

And, between 1997-2002, private and public spending on mental disorders grew by nearly one-third, to a level comparable with what is spent fighting cancer and pulmonary diseases.

Some counter that the problem is "parity" -- insurers sometimes restrict mental health benefits more than they do for other services. But this comparison is not clear-cut.

Should "treatment" include all disorders recognized by the psychiatric profession's Diagnostic and Statistical Manual, which one version of the federal bill treats as gospel? The DSM contains "disorders" such as an inability to express oneself in words. How could such a liberal interpretation not make it tougher to afford insurance?

Backers of parity claim the parity mandate didn't significantly inflate costs in the Federal Employee Health Benefit program. The trouble is, FEHBP had a huge managed-care component that simply restricted eligibility.

What about exemptions for smaller firms, and provisions allowing "opt-outs" if coverage costs increase excessively? Parity advocates in the House of Representatives seem reluctant to accept compromises like these in final legislation. Chief sponsor Rep. Patrick Kennedy, D-R.I., noted, "We can't cut any deals with insurance companies. We need to strengthen the Senate bill."

If Draconian provisions prevail, so could across-the-board benefit cuts or deductible increases.

State experiences provide other clues. The Center for Freedom and Prosperity, a free-market think tank, has determined that the number of health coverage mandates imposed by a state is associated with greater numbers of uninsured people.

The Council for Affordable Health Insurance, whose membership includes some insurers, calculated that costs can jump 5 percent to 10 percent in states that stipulate mental health parity.

A federal policy may not lead to such misery, but at a time of stagnant job creation and eroding incomes, shouldn't policy-makers be thinking of ways to lower the overhead employers face?

The American Psychiatric Association touts its poll reporting most Americans favor mental health parity. By that same survey, though, nearly 75 percent name money as the No. 1 factor affecting their stress level, while almost half cite job insecurity as a concern. These are critical mental health issues, too, ones that parity could actually hurt.

Neither will parity help to insure the 30 million-plus citizens who have no private health coverage at all.

In the end, is it really smart to give more power over our health care to a government that squanders $20 billion every year on improper health care payments, repeatedly underestimates the cost of Medicaid mandates on the states and is on track to bankrupt Medicare's Hospital Insurance program?

Fortunately, we have a more effective alternative. The Health Care Choice Act, supported by 53 House members, would permit individuals and businesses to buy insurance from out-of-state providers instead of being forced to pay premiums for items such as fertility treatments and massages because of state mandates.

The Health Care Choice Act would encourage business competition and give access to a broader range of plans, so consumers would have more choices at lower costs.

When combined with other measures such as tax credits for the uninsured and individually controlled health savings accounts, the Health Care Choice Act would allow millions more of us to choose mental health coverage in an insurance package we can afford. To me that's more peace of mind than parity can possibly deliver.

This article appeared in McClatchy newspapers nationwide.