[Congressional Record Volume 145, Number 78 (Thursday, May 27, 1999)]
[Extensions of Remarks]
[Pages E1121-E1122]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 INTRODUCTION OF H.R. 1977, THE HAROLD HUGHES, BILL EMERSON SUBSTANCE 
                       ABUSE TREATMENT PARITY ACT

                                 ______
                                 

                            HON. JIM RAMSTAD

                              of minnesota

                    in the house of representatives

                         Thursday, May 27, 1999

  Mr. RAMSTAD. Mr. Speaker, every day, politicians talk about the goal 
of a ``drug-free America.''
  Mr. Speaker, let's get real! We will never even come close to a drug-
free America until we knock down the barriers to chemical dependency 
treatment for the 26 million American people presently addicted to 
drugs and/or alcohol.
  That's right, Mr. Speaker. 26 million alcoholics and addicts in the 
United States today.
  150,000 Americans died last year from drug and alcohol addiction.
  Alcohol and drug addiction, in economic terms, cost the American 
people $246 billion last year. American taxpayers paid over $150 
billion for drug-related criminal and medical costs alone in 1997--more 
than they spent on education, transportation, agriculture, energy, 
space and foreign aid combined.
  According to the Health Insurance Association of America, each 
delivery of a new child that is complicated by chemical addiction 
results in an expenditure of $48,000 to $150,000 in maternity care, 
physicians' fees and hospital charges. We also know that 65 percent of 
emergency room visits are drug/alcohol related.
  The National Center on Addiction and Substance Abuse found that 80 
percent of the 1.7 million prisoners in America are behind bars because 
of drugs and/or alcohol addiction.
  Another recent study showed that 85 percent of child abuse cases 
involve a parent who abuses alcohol or other drugs. 70 percent of all 
people arrested test positive for drugs. Two-thirds of all murders are 
drug-related.
  Mr. Speaker, how much evidence does Congress need that we have a 
national epidemic of addiction? An epidemic crying out for a solution 
that works. Not more cheap political rhetoric. Not more simplistic, 
quick fixes that obviously are not working.
  Mr. Speaker, we must get to the root cause of addiction and treat it 
like other diseases. The American Medical Association told Congress and 
the nation in 1956 that alcoholism and drug addiction are a disease 
that requires treatment to recover.
  Yet today in America only 2 percent of the 16 million alcoholics and 
addicts covered by health plans are able to receive adequate treatment.
  That's right. Only 2 percent of alcoholics and addicts covered by 
health insurance plans are receiving effective treatment for their 
chemical dependency, notwithstanding the purported ``coverage'' of 
treatment by their health plans.
  That's because of discriminatory caps, artificially high deductibles 
and copayments, limited treatment stays as well as other restrictions 
on chemical dependency treatment that are different from other 
diseases.
  If we are really serious about reducing illegal drug use in America, 
we must address the disease of addiction by putting chemical dependency 
treatment on par with treatment for other diseases. Providing equal 
access to chemical dependency treatment is not only the prescribed 
medical approach; it's also the cost-effective approach.
  We have all the empirical data, including actuarial studies, to prove 
that parity for chemical dependency treatment will save billions of 
dollars nationally while not raising premiums more than one-half of one 
percent, in the worst case scenario!
  It's well-documented that every dollar spent for treatment saves $7 
in health care costs, criminal justice costs and lost productivity from 
job absenteeism, injuries and sub-par work performance.
  A number of studies have shown that health care costs, alone, are 100 
percent higher for untreated alcoholics and addicts compared to 
recovering people who have received treatment.
  Mr. Speaker, as a recovering alcoholic myself, I know firsthand the 
value of treatment. As a recovering person of almost 18 years, I am 
absolutely alarmed by the dwindling access to treatment for people who 
need it. Over half of the treatment beds are gone that were available 
10 years ago. Even more alarming, 60 percent of the adolescent 
treatment beds are gone.
  Mr. Speaker, we must act now to reverse this alarming trend. We must 
act now to provide greater access to chemical dependency treatment.
  That's why today I am introducing the Harold Hughes, Bill Emerson 
Substance Abuse Treatment Parity Act--the same bill that had the broad, 
bipartisan support last year of 95 cosponsors.
  This legislation would provide access to treatment by prohibiting 
discrimination against the disease of addiction. The bill prohibits 
discriminatory caps, higher deductibles and copayments, limited 
treatment stays and other restrictions on chemical dependency treatment 
that are different from other diseases.
  This is not another mandate because it does not require any health 
plan which does not already cover chemical dependency treatment to 
provide such coverage. It merely says those which offer chemical 
dependency coverage cannot treat it differently from coverage for 
medical or surgical services for other diseases.
  In addition, the legislation waives the parity for substance abuse 
treatment if premiums increase by more than 1 percent and exempts small 
businesses with fewer than 50 employees.
  Mr. Speaker, it's time to knock down the barriers to chemical 
dependency treatment. It's time to end the discrimination against 
people with addiction.
  It's time to provide access to treatment to deal with America's No. 1 
public health and public safety problem.
  We can deal with this epidemic now or deal with it later.
  But it will only get worse if we continue to allow discrimination 
against the disease of addiction.
  As last year's television documentary by Bill Moyers pointed out, 
medical experts and treatment professionals agree that providing access 
to chemical dependency treatment is the only way to combat addiction in 
America. We can build all the fences on our borders and all the prison 
cells that money can buy. We can hire thousands of new border guards 
and drug enforcement officers. But simply dealing with the supply side 
of this problem will never solve it.
  That's because our nation's supply side emphasis does not adequately 
attack the underlying problem. The problem is more than illegal drugs 
coming into our country; the problem is the addiction that causes 
people to crave and demand those drugs. We need more than simply tough 
law enforcement and interdiction; we need extensive education and 
access to treatment.
  Drug Czar Barry McCaffrey understands. He said recently, ``Chemical 
dependency treatment is more effective than cancer treatment, and it's 
cheaper.'' General McCaffrey also said, ``We need to redouble our 
efforts to insure that quality treatment is available.''
  Mr. Speaker, General McCaffrey is right and all the studies back him 
up. Treatment does work and it is cost-effective.
  Last September, the first national study of chemical dependency 
treatment results confirmed that illegal drug and alcohol use are 
substantially reduced following treatment. This study, by the Substance 
Abuse and Mental Health Services Administration, shows that treatment 
rebuilds lives, puts families back together and restores substance 
abusers to productivity.
  According to Dr. Ronald Smith, Captain, Navy Medical Corps and former 
Vice Chairman of Psychiatry at the National Naval Medical Center, the 
U.S. Navy substance abuse treatment program has an overall recovery 
rate of 75 percent.

[[Page E1122]]

  The Journal of the American Medical Association (JAMA) on April 15, 
1998 reported that a major review of more than 600 research articles 
and original data conclusively showed that ``addiction conforms to the 
common expectations for chronic illness and addiction treatment has 
outcomes comparable to other chronic conditions.'' It states that 
relapse rates for treatment for drug/alcohol addiction (40%) compare 
favorably with those for 3 other chronic disorders: adult-onset 
diabetes (50%), hypertension (30%) and adult asthma (30%).
  A March 1998 GAO report also surveyed the various studies on the 
effectiveness of treatment and concluded that treatment is effective 
and beneficial in the majority of cases.
  A number of state studies also show that treatment is cost-effective 
and good preventive medicine.
  A Minnesota study extensively evaluated the effectiveness of its 
treatment programs and found that Minnesota saves $22 million in annual 
health care costs because of treatment.
  A California study reported a 17 percent improvement in other health 
conditions following treatment--and dramatic decreases in 
hospitalizations.
  A New Jersey study by Rutgers University found that untreated 
alcoholics incur general health care costs 100 percent higher than 
those who receive treatment.
  So, the cost savings and effectiveness of chemical dependency 
treatment are well-documented. But putting the huge cost-savings aside 
for a minute, what will treatment parity cost?
  First, there is no cost to the federal budget. Parity does not apply 
to FEHBP, Medicare or Medicaid.
  First, there is no cost to the federal budget. Parity does not apply 
to FEHBP, Medicare or Medicaid.
  According to a national research study that based projected costs on 
data from states which have already enacted chemical dependency 
treatment parity, the average premium increase due to full parity would 
be 0.2 percent. (Mathematical Policy Research study, March 1998)
  A Milliman and Robertson study projected the worst-case increase to 
be 0.5 percent, or 66 cents a month per insured.
  That means, under the worst-case scenario, 16 million alcoholics and 
addicts could receive treatment for the price of a cup of coffee per 
month to the 113 million Americans covered by health plans. At the same 
time, the American people would realize $5.4 billion in cost-savings 
from treatment parity, according to the California Drug and Alcohol 
Treatment Assessment.
  U.S. companies that provide treatment have already achieved 
substantial savings. Chevron reports saving $10 for each $1 spent on 
treatment. GPU saved $6 for every $1 spent. United Airlines reports a 
$17 return for every dollar spent on treatment.
  And, Mr. Speaker, no dollar value can quantify the impact that 
greater access to treatment will have on the spouses, children and 
families who have been affected by the ravages of addiction. Broken 
families, shattered lives, messed-up kids, ruined careers.
  Mr. Speaker, this is not just another policy issue. This is a life-
or-death issue for 16 million Americans who are chemically dependent, 
covered by health insurance but unable to access treatment.
  We know one thing for sure. Addiction, if not treated, is fatal. 
That's right--addiction is a fatal disease.
  Last year, 95 House members from both sides of the political aisle 
co-sponsored this substance abuse treatment parity legislation.
  This year, let's knock down the barriers to treatment for 16 million 
Americans.
  This year, let's do the right thing and the cost effective thing and 
provide access to treatment.
  This year, let's pass treatment parity legislation to deal with the 
epidemic of addiction in America.
  Mr. Speaker, the American people cannot afford to wait any longer.
  I urge all members to cosponsor the Harold Hughes, Bill Emerson 
Substance Abuse Treatment Parity Act.

                          ____________________