Legislators stonewall fairness

By Robert Landauer – editorial columnist for The Oregonian, June 29, 1999. Not available elsewhere online.

Our lawmakers in Salem are more open to a good scare than to good advice.

The basic points are clear in their quivering handling of a medical insurance issue:

  • Scientists have proved that some serious mental illnesses are biologically based and can be treated medically.
  • Workers with company-paid health plans want treatable mental illnesses such as schizophrenia and major depression to get the same coverage as physical ailments such as diabetes and epilepsy. Anything less, they say, is discrimination.
  • Some employers fear that parity for mental illnesses would produce runaway costs. Lobbyists say this would force firms to drop all mental -disorder coverage, harming other Oregonians. However, fewer than 1 percent of companies dropped coverage as a result of the 1996 federal parity law.
  • Overwhelming evidence shows that insurance parity for mental illness is cost-effective. Twenty-five states have adopted parity; two more bills await governors’ signatures.

Legislators here, though, are set to keep our separate and unequal system.

“This Legislature has conducted a stalling action in refusing to hold even one public hearing,” Doris Cameron-Minard, president of the Oregon chapter of the National Alliance for the Mentally Ill, said last week.

Public opinion and cost aren’t valid alibis for delay or piecemeal action.

A 1999 survey of 500 voters conducted for the Oregon Medical Association by Moore Information found that 85 percent favor or strongly favor requiring insurance companies to pay the same level of benefits for mental and physical illnesses.

Rand Corp. found that equalizing annual limits would increase costs by about $1 per worker per year under managed care.

A 1999 study for 14 Oregon organizations by PricewaterhouseCoopers found that parity’s net effect — costs minus benefits — would be to raise employers’ health outlays 1.2 percent, or $1.27 per member per month.

Assuming an average of three members per family, that cost increase translates to a pay raise of $.022 per hour — one-fifth of 1 cent.

Stonewalling over such a paltry sum is more than chintzy; it is contemptible.

The human face of our lawmakers’ embracing old error rather than new truth is grotesque, too.

Families in Oregon run out of mental illness insurance every year.

“Then they use money intended for one child’s education to pay for the health care of another,” says Portland lawyer Phillip D. Chadsey.

Finally, they face bankruptcy as they try to pay for loved ones’ treatments.

The earlier and the more adequately the mentally ill get treatment, the better the chances of recovery.

The community pays for neglect. The costs add up in joblessness, homelessness, jailings, hospitalizations and referrals to the Oregon Health Plan, foster care and other public assistance.

Also, as the system operates now, so many restrictions have been placed on covered mental health visits that it often is tough to do what is medically appropriate or necessary, says Dr. Mark Olfson of Columbia University, a researcher in the field.

Susan Dore, who studies parity for the National Alliance for the Mentally Ill, underlines his point:

“You don’t do one coronary bypass if a patient needs three. If patients need weekly therapy and you allow fewer visits along with prescriptions they can’t afford to fill, don’t act surprised that they live on the streets with ulcerated feet.”

Oregon is coldheartedly falling a decade behind most states.