Mental Health Parity

[Guest guest]

Thanks Jule for letting us know about the mental health parity bill. I will

be contacting my senator!

in S.D.

[Guest guest]

In a message dated 4/20/2006 9:29:05 PM Pacific Standard Time,

SSRI medications writes:

I, for one, do NOT want mental health parity!

Mental health parity would mean MORE $ to pharma and the mental

health industry, MORE people being diagnosed with fraudulent labels

and put on harmful psych drugs.

Oh not this elephant in the living room again. So called mental illnesses

should not be on a par with physical illnesses. This is all so stupid. I'm

telling my elected servants to vote NO! It's just a great big windfall for

BIG PHARMA. It's a scam. They should outlaw all mental illnesses and stop

doping us.

[Guest guest]

In a message dated 4/20/2006 9:29:05 PM Pacific Standard Time,

SSRI medications writes:

I, for one, do NOT want mental health parity!

Mental health parity would mean MORE $ to pharma and the mental

health industry, MORE people being diagnosed with fraudulent labels

and put on harmful psych drugs.

Oh not this elephant in the living room again. So called mental illnesses

should not be on a par with physical illnesses. This is all so stupid. I'm

telling my elected servants to vote NO! It's just a great big windfall for

BIG PHARMA. It's a scam. They should outlaw all mental illnesses and stop

doping us.

[Guest guest]

In a message dated 4/20/2006 9:29:05 PM Pacific Standard Time,

SSRI medications writes:

I, for one, do NOT want mental health parity!

Mental health parity would mean MORE $ to pharma and the mental

health industry, MORE people being diagnosed with fraudulent labels

and put on harmful psych drugs.

Oh not this elephant in the living room again. So called mental illnesses

should not be on a par with physical illnesses. This is all so stupid. I'm

telling my elected servants to vote NO! It's just a great big windfall for

BIG PHARMA. It's a scam. They should outlaw all mental illnesses and stop

doping us.

[Guest guest]

In a message dated 4/20/2006 9:29:05 PM Pacific Standard Time,

SSRI medications writes:

I, for one, do NOT want mental health parity!

Mental health parity would mean MORE $ to pharma and the mental

health industry, MORE people being diagnosed with fraudulent labels

and put on harmful psych drugs.

Oh not this elephant in the living room again. So called mental illnesses

should not be on a par with physical illnesses. This is all so stupid. I'm

telling my elected servants to vote NO! It's just a great big windfall for

BIG PHARMA. It's a scam. They should outlaw all mental illnesses and stop

doping us.

[Guest guest]

Dear Friend of ASO:

An additional request on behalf of mental health parity in Ohio. Enacting mental health insurance parity was one of the recommendations of the Ohio Autism Taskforce. FYI - Please share.

Sincerely,

Barbara C. YavorcikPresidentAutism Society of Ohio701 S. Main St.Akron, OH 44311(330) 376-0211fax: (330) 376-1226email: askASO@...home: byavorcik@...web: www.autismohio.org----------------------------------------------------------------------

All Mental Health Parity Advocates

The following article appeared on the front page of the Sunday edition of the Columbus Dispatch. As the main article of a series of articles written by Dispatch reporter Encarnita Pyle, this was the culmination of months of work on her part to document the injustice that exists in Ohio insurance laws. Encarnita’s byline has appeared over the past several years on dozens of articles exposing many of the problems experienced by Ohio’s families in trying to get much-needed treatment for their loved ones. She has also done a good job of demonstrating that treatment works when available by spotlighting the success stories that exist in Ohio and around the state.

Please read the article and pass it along to others in your advocacy network. Ask them, as I am asking you now, to send a short thank you note to Encarnita Pyle at epyle@... to thank her for her hard work and to encourage her to continue to shine a light on the inequity that is allowed to exist regarding the need for insurance parity in Ohio. By showing our support, her editors will allow her to continue with this campaign, assisting the advocacy efforts to get HB 180 and SB 116, Mental Health Parity passed in the Ohio General Assembly.

Thank you.

UNCOVERED

In Ohio, insurance pays much more for physical ailments than mental ones

Published: Sunday, July 9, 2006

By Encarnacion Pyle

THE COLUMBUS DISPATCH

Mental illness in the U.S.

A baby sitter sexually assaulted Matt Mikolic at gunpoint when he was in kindergarten. At age 7, he ran into traffic, jabbed pencils into his skin and threw himself into bed every night, yelling, "I want to die." By middle school, Matt had chased his younger brother with a knife and had tried to throw himself from the roof of his house. He had been hospitalized twice.

When doctors diagnosed bipolar, attention-deficit and post-traumatic-stress disorders in Matt, now 18, his parents were relieved to have health insurance, which they assumed would cover the cost of his care.

Then their younger son, , now 16, also started showing signs of bipolar disorder, which causes alternating periods of mania and desolation.

They, too, sank into depression.

Soon, Mikolic, 46, and her husband, , 52, were paying as much as $500 a week so they could all see a psychiatrist. Most of it came out of their own pockets because of limitations on their insurance coverage.

"My husband and I are college-educated, professional people, earning good wages, but a family can't keep up with bills like this on an ongoing basis," Mrs. Mikolic said.

Each year, insurance typically covers no more than 20 mental-health visits and 10 hospital days a year for hundreds of thousands of families. Maximum lifetime coverage for mental illness typically is $10,000, compared with $1 million for general-health coverage.

Advocates of more coverage for the mentally ill often point to Parkinson's disease and schizophrenia as examples of two illnesses that are treated differently. The two are linked by dopamine, a chemical in the brain that acts like a spark plug, initiating memory, mood and motor behavior. People with schizophrenia have too much dopamine; people with Parkinson's have too little.

But a Parkinson's patient usually enjoys full medical coverage, while people with schizophrenia often face limited benefits and increased co-payments.

"Poor will, poor spirit or poor choices are not invoked as reasons to limit coverage with Parkinson's disease," said Dr. Sul Ross Thorward, a psychiatrist at Twin Valley Behavioral Healthcare, the state mental hospital in Columbus. "We're all familiar with Muhammad Ali and J. Fox. No implications are made that this illness is the patient's fault."

Thirty-five states require mental illnesses to be covered the same as physical ailments. Some Ohio lawmakers have tried unsuccessfully for 18 years to prevent insurers from restricting mental-health coverage.

"We have found no reason based on biomedical or behavioral science why mental disorders should be treated differently from any other medical disorder," said . E. Hyman, former director of the National Institute of Mental Health.

Insurance companies and small-business owners say equal coverage would drive up their costs.

"Legislators have considered bills mandating insurance coverage for diabetes, maternity hospital stays, birth control, osteoporosis, infant formula and mental-health parity," said Fitzgibbon, director of the Ohio Chamber of Commerce's Small Business Council. "Although each mandate may be viewed as an attractive, expedient solution for a particular health problem, the cumulative economic cost is staggering."

But advocates say the increases would amount to less than 1 percent, based on the experience of states that offer parity.

"The arguments against parity are only justifications for the discrimination of the mentally ill because they are seen as having less political clout and power than people without these illnesses," said Terry , who retired as executive director of the Ohio chapter of the National Alliance for the Mentally Ill at the end of June. "Nothing could be more cruel or un-American."

Staggering financial toll

Over the past decade, the Mikolics have dug a $500,000 financial hole.

They took out three home-equity loans but still ended up selling their $287,000 house in Willoughby, a Cleveland suburb.

"If my child had leukemia, we would not have lost our home. We would not be broke," said Mrs. Mikolic, a former nurse who advises educators about emotionally disturbed students.

"Mental illnesses are real medical conditions -- just like heart disease and cancer -- that affect more than 500,000 adults and children in Ohio every year," said Moskow Sigal, executive director of the Mental Health Association of lin County.

"It's not fair to the individuals and their families to be denied coverage. And it's not fair to taxpayers who must subsidize the ever-growing public mental-health system that steps in when people exhaust their private insurance benefits."

Nichols, 46, of Maineville, northeast of Cincinnati, paid more last year for mental-health services than for treatment of several physical ailments, including a heart attack, hypertension and a torn ligament in her ankle.

"I'm normally physically healthy, but I had a bad year," said Nichols, a social worker who has bipolar disorder. "My medical expenses totaled $47,478, of which I paid $1,673.

"My psychiatric bills only totaled $3,071, but I still paid $1,910."

When her son, Zachary, now 18, was treated for leukemia, insurance covered everything but his $10 co-pay.

Meanwhile, Nichols has spent an average of $8,000 annually for office visits and tests not covered by insurance because they relate to her mental illness. She owes her psychiatrist $28,000.

"I don't understand why insurance companies don't pay more for psychiatric care when studies show mental illnesses are often treated more successfully than common medical problems," she said.

Benefits of treatment

Studies by the U.S. Department of Health and Human Services indicate that doctor visits, medication and therapy reduce hospital stays, one of the most expensive forms of treatment at an average of $500 a day.

Sometimes a trip to the hospital can't be avoided but insurance companies won't cover it.

During a violent outburst in 2001, Meg 's son, Leif, then 10, tripped his sister, Emma, who was 4.

, of the Northwest Side, called police. Officers took Leif to Netcare, lin County's 24-hour emergency mental-health center, and later to Ohio State University Harding Hospital.

The family's insurance company wouldn't approve the claim, but called her son's psychiatrist, who talked the company into changing its mind. Leif had been treated for depression. The next day, his bipolar disorder, obsessive-compulsive disorder and separation anxiety were diagnosed.

"If I had taken my son to the hospital with a sprained arm, they wouldn't have said, 'Sorry, we can't help you,' " said.

Sometimes, people go without treatment.

"Suicide, a common byproduct of untreated mental illness, claims more lives annually than homicide," state Rep. Jon said. , a Delaware Republican, and Sen. Spada, a Republican from North Royalton, both introduced parity bills last year that have stalled in the state legislature.

Both bills would require employers to offer basic health insurance that includes coverage of "biologically based mental illnesses" such as bipolar disorder, major depression, schizophrenia and obsessive-compulsive disorder.

The bills would extend benefits now provided to state employees.

The state expected to spend $10.2 million on employees' mental-health services last fiscal year, which ended June 30. Physical disorders were projected to cost $345.8 million, said Ben Piscitelli, spokesman for the Ohio Department of Administrative Services.

Two years ago, Gov. Bob Taft called for a moratorium on new health-care mandates on businesses. He still opposes the parity bills, spokesman Mark Rickel said.

Unlike previous proposals, the bills wouldn't require coverage for conditions resulting from drug or alcohol abuse. They would allow companies to decline to buy mental-health services if the new coverage caused their insurance premiums to rise more than 1 percent over six months.

"We've compromised time after time," said Cheri L. Walter, chief executive of the Ohio Association of County Behavioral Health Authorities, which represents drug, alcohol and mental-health treatment providers statewide. "The bills can't be watered down any more and still be useful."

Parity bills debated

But some business leaders say protections are needed because the percentage increase for some companies could be in the double digits.

"Companies with the most mentally ill employees in need of coverage will likely pass any increased costs on by raising co-pays and deductibles, lowering wages or discontinuing the insurance," Fitzgibbon of the chamber said.

Among businesses with 10 or fewer employees, 41 percent provide at least basic coverage, which by state law is $550 a year, said Ty Pine, who heads the 36,000-member National Federation of Independent Business-Ohio.

"Since 1986, the No. 1 concern of small-business owners -- above government regulations, paperwork requirements and even taxes -- is the cost of health insurance."

The legislation would cover only one-third of Ohioans who have insurance, Pine said.

Advocates say the bills would extend coverage to about 110,000 Ohio workers and their families. State and federal employees, as well as Ohioans on Medicaid or Medicare, receive some sort of parity. Large, self-insured companies are not subject to state parity laws but have to live up to federal requirements and are regulated by the U.S. Department of Labor.

Advocates also say the financial concerns haven't been borne out in states that have required parity for years.

Two-thirds of businesses in Vermont said parity had "little or no effect" on their costs. A New England Journal of Medicine study found that six out of seven federal health-care plans studied were no more expensive than conventional plans. And the Chevron Corp. found it saved $7 for every dollar it spent on mental health through its employee-assistance program.

Twenty states with parity laws have higher insurance rates than Ohio; 15 have lower rates.

The National Institute of Mental Health estimates the cost of untreated mental illness at $300 billion a year in the form of absenteeism, bankruptcy, crime, homelessness and poverty. In Ohio, the cost is projected at more than $6.5 billion a year, say the Ohio Association of County Behavioral Health Authorities and the U.S. surgeon general.

Spada was caught by surprise over Labor Day weekend 2003 when his son was hospitalized in a mental-health ward.

"I did not have a clue as to what to expect," he said.

Doctors later diagnosed bipolar disorder in . With counseling, family support and medication, he finished a master's degree in economics and started working full time.

"It's time insurance companies treat a sick mind the same they would a sick heart," Spada said.

Research for the stories in this package was conducted with the help of a lynn Fellowship for Mental Health Journalism. The fellowship program is run out of the Center in Atlanta.

epyle@...

Illustration: Photo appeared in newspaper, not in the archive.

Photo caption: ERIC ALBRECHT| DISPATCHMatt Mikolic, shown with his mother, , has endured a lengthy battle with bipolar disorder that has cost his family hundreds of thousands of dollars. He no longer requires his medication, and he intends to go to college and pursue a career as an advocate for people with mental illnesses.ERIC ALBRECHT| DISPATCHMatt Mikolic overcame bipolar disorder and other mental illnesses to graduate in June from Eastlake High School. Leaving the State Theatre Square in Cleveland with him after the ceremony is his mom, .

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