March 7th, 2008 The trade-offs in mental health parity Posted by Dana Blankenhorn @ 7:11 am The U.S. House, for the first time, has passed a bill giving mental health insurance parity with physical health. But a look at blogger reaction shows the trade-offs here remain daunting, even for advocates. Over at DailyKos theres worry the bill may actually cut care in states like California, which already require some mental health coverage. The key word there is some. The House bill wants coverage for all DSM-IV illnesses. California covers just nine of the most serious issues. Cliff Schecter is more worried about a provision which would push Medicare patients out of the some of our best hospitals, in order to offset the new costs. While your TV news may focus, if it focuses at all, on the fact that Patrick Kennedy pushed the House bill and his father, Sen. Edward Kennedy, the competing Senate bill, the fact is even liberals seem to fear the younger man over-reached, and in so doing made compromises which are counter-productive. The result is, just as with the previous Republican Congress, we may get no bill at all. The elder Kennedy plans no conference on the competing bills, expecting Administration veto threats will force the House to cave in to his version. The Senate bill, which passed unanimously with co-sponsor Sen. Pete Domenici of New Mexico, simply requires those plans which cover both mental and physical illness to do so with similar limits and co-pays. An obvious part of the problem here is that while physical illness is generally defined, in terms of care and costs, mental illness often isnt. While its possible some of those 1% of us now in jail might not have committed those crimes with mental health treatment, even that is hard to quantify. Drug therapy makes mental illness costs easier to quantify, but in many cases drugs dont bring complete relief, only masking symptoms which therapy is needed to reach. And theres the rub. Therapy can provide a permanent cure, but it cant really guarantee anything. I went through therapy for years before finding someone who could reach my ADD mind with the coaching it needed to start the recovery process. Thus I know much of our mental health funding is wasted, even when everyone is being honest, and thus mental health treatment fails to fit the definition of insurance nothing is sure. Until we can deal with this reality and create some quantification on mental health costs, as we have with physical health costs, its hard to see anything but hard trade-offs anywhere. Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994.