This article by Robert Pear from today’s New York Times talks about the differences in the two mental health parity bills being considered in Congress, one bill sponsored by by Patrick Kennedy and one by his father, Ted Kennedy.
Proposals for Mental Health Parity Pit a Fatherâ€™s Pragmatism Against a Sonâ€™s Passion
WASHINGTON, March 18 â€” Itâ€™s Kennedy versus Kennedy as two members of Congress from the same family face off over competing versions of legislation that would require many health insurance companies and employers to provide more generous benefits to people with mental illness.
Representative Patrick J. Kennedy, Democrat of Rhode Island and chief sponsor of the House bill, has criticized as inadequate the Senate bill introduced by his father, Senator Edward M. Kennedy, Democrat of Massachusetts. Representative Kennedy is trying to mobilize mental health advocates to lobby for what he describes as â€œthe stronger of the two bills, the House bill.â€?
Both bills seek to end discrimination against people with mental disorders by requiring insurers and employers to provide equivalent coverage, or parity, for mental and physical illnesses.
That would be a huge change. For decades, insurers have charged higher co-payments and set stricter limits on coverage of mental health services. For example, insurers often refuse to cover more than 20 visits a year to a psychotherapist. And a patient may have to pay 20 percent of the cost for visiting a cancer specialist, but 40 percent or more for a mental health specialist. [full text]
It’s beginning to look like mental health parity legislation is going to happen, one way or another. Which is a good thing — don’t get me wrong. I am a mental health practitioner and I believe in quality mental health care as a cornestone of basic health. But I like to remind everyone that much of diagnosis is largely a subjective endeavor, and in the case of mental health diagnosis the subjectiveness increases a hundredfold. I also think it’s important to acknowledge that pharmaceutical companies may have a huge stake in seeing that mental health parity legislation is enacted. Strangely, this corporate influence is not mentioned at all in this New York Times article. I am going to take a wild guess and say that pharmaceutical companies will be cheering when mental health parity legislation is passed.
Margaret Atwood has a futuristic novel called Oryx and Crake in which it is a hundred years in the future, and basically the pharmaceutical companies run everything. New York and much of the Eastern Seaboard have all fallen into the rising Atlantic sea, and what is left of the world is divided into the compounds of corporations such as OrganInc Farms and Helth Wyzer. It is a nanotech biochem world, a fairly orderly (if fascistic) and affluent world within the compounds, but out in the Pleeblands, viruses run rampant and people live in relative disarray and poverty — but they seem to be having a better time than those living under Pharmaceutical Rule. People in the compounds can’t go into the Pleeblands though, or they risk being swallowed up by all the viruses that they are not immune to.
My concern about mental health parity is that we may be writing a blank check to the pharmaceutical industry. We have called attention to one are in which the proliferation of pharmaceutical influence seems pretty clear — the issue of medicating children. I believe that in enacting mental health parity, we need to make sure there are adequate protections in place for children, families, and people in general to resist and refuse pharmaceutical intervention. There also needs to be a stronger effort to conduct science research that is not largely funded by pharmaceutical corporations. We have seen many drugs, both psychotropic and medical, put on the market with major side effects, some of which are life-threatening.
We all owe a great deal to the medical advances of the past century, including the huge advances in pharmaceuticals. But they are a corporate entity like any other, working primarily to strengthen their profits. They need to be kept in check so that health is always prioritized, not sidelined by the profit motive.