The Murky Politics of Mind-Body

Now a critical moment has been reached in a 15-year debate in statehouses and in Congress over whether treatment for problems like depression, addiction and schizophrenia should get the same coverage by insurance companies as, say, diabetes, heart disease and cancer.This month, the House passed a bill that would require insurance companies to provide mental health insurance parity. It was the first time it has approved a proposal so substantial.The bill would ban insurance companies from setting lower limits on treatment for mental health problems than on treatment for physical problems, including doctor visits and hospital stays. It would also disallow higher co-payments. The insurance industry is up in arms, as are others who envision sharply higher premiums and a free-for-all over claims for coverage of things like jet lag and caffeine addiction. Parity raises all sorts of tricky questions. Is an ailment a legitimate disease if you can’t test for it? A culture tells the doctor the patient has strep throat. But if a patient says, ‘‘Doctor, I feel hopeless,’’ is that enough to justify a diagnosis of depression and health benefits to pay for treatment? How many therapy sessions are enough? If mental illness never ends, which is typically the case, how do you set a standard for coverage equal to that for physical ailments, many of which do end?

House Approves Bill on Mental Health Parity

After more than a decade of struggle, the House on Wednesday passed a bill requiring most group health plans to provide more generous coverage for treatment of mental illnesses, comparable to what they provide for physical illnesses. The vote was 268 to 148, with 47 Republicans joining 221 Democrats in support of the measure. The Senate has passed a similar bill requiring equivalence, or parity, in coverage of mental and physical ailments. Federal law now allows insurers to discriminate, and most do so, by setting higher co-payments or stricter limits on mental health benefits.

Senate Passes Mental Health Parity Bill

The Senate passed legislation Tuesday night that would require equal health insurance coverage for mental and physical illnesses when policies cover both. The bill, which passed by unanimous consent, moves advocates one step closer in their years-long quest for a concept known as mental health parity.
"The passage tonight of the Mental Health Parity bill underscores our commitment to treat all patients facing all diseases with the dignity and respect they deserve," said Sen. Edward Kennedy, D-Mass. "This new legislation will bring dramatic new help to millions of Americans who today are denied needed mental health care and treatment." Passage came on the same day that supporters inundated House Speaker Nancy Pelosi's office, urging a vote on mental health parity legislation in the House.