[Congressional Record Volume 148, Number 52 (Wednesday, May 1, 2002)]
[Senate]
[Pages S3586-S3587]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          MENTAL HEALTH PARITY

  Mr. WELLSTONE. Mr. President, I ask unanimous consent to have printed 
in the Record two editorials--one from the New York Times, and one from 
the Minneapolis Star Tribune--about the importance of ending 
discrimination in mental health coverage and calling for full mental 
health parity.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

            [From the Minneapolis Star Tribune, May 1, 2002]

            Brain Storm At Last, Bush Grasps a Medical Fact

       President Bush took a grand leap on Monday--one many 
     observers thought he'd never dare to take. He at last 
     acknowledged that the brain is a part of the body.
       Scientists, of course, have suspected as much for years; 
     the president's declaration is sure to bolster their self-
     esteem. It will also open the door to a long-awaited policy 
     change: If the brain is in fact yet another bodily organ, it 
     certainly makes sense that its disorders be covered by the 
     same medical-insurance rules that apply to every other bodily 
     dysfunction.
       This logic is not lost on the president, and on Monday he 
     want out of his way to endorse legislation that would force 
     insurers to treat brain disorders just like other medical 
     illnesses. That would bring an end to the practice of 
     assuring ample health coverage when the pancreas peters out 
     of insulin but scrimping on care when the brain is short on 
     serotonin. That sort of discrimination keeps sick people 
     sick, Bush said, and contributes to the stigma suffered by 
     people with brain diseases. The answer, Bush made plain, is 
     ``full mental health parity''--a promise he says he'll work 
     with Congress to fulfill.
       This is phenomenal news, and it has the bill's top backers 
     over the moon. Sen. Paul Wellstone's name may have been 
     omitted as the president pushed his concept, but the 
     Minnesota senator is too happy to care. Last year his mental 
     health parity bill died an ignominious death in conference 
     committee, after administration and Republican leaders 
     buckled to insurers' complaints that the bill would be too 
     costly.
       Medical coverage for the brain--too costly to cover? Tell 
     that to America's epileptics, whose disability has long been 
     covered because it's no longer considered ``mental.'' 
     Besides, the claim about costliness was nonsense from the 
     start. The Congressional Budget Office estimates that 
     premiums would rise less than 1 percent if parity were 
     assured. And that calculation doesn't take into account the 
     savings that could be reaped if--as is likely--early and 
     habitual treatment of brain disorders led to fewer emergency-
     room visits, shorter psychiatric hospitalizations and reduced 
     prison stays.
       Of course the best reason to assure mental-health parity, 
     as Wellstone and Republican cosponsor Pete Domenici of New 
     Mexico have argued, is that it's the decent thing to do. Bush 
     said just that on Monday, lamenting the history of 
     misunderstanding, fear and shame that has haunted people 
     suffering from neglected but fully treatable brain disorders. 
     The way to banish those horrors is to treat the medical 
     afflictions with medicine--wherever in the human frame they 
     occur.
       This is a terrific pledge from a once-reluctant president, 
     and onlookers who see parity as a no-brainer should make sure 
     he sticks by his word. As Wellstone observed earlier this 
     month while speaking to mental-health experts in Bethesda, 
     Md., much could still go awry as this measure moves through 
     Congress over the next month. Though the Wellstone-Domenici 
     bill calls for covering all mental illnesses, many foes favor 
     letting legislators or health plans pare down the list to a 
     few coverable--perhaps just the few curable--diagnoses. That 
     could leave many of the sickest entirely uncovered. There's 
     also the ominous danger posed by the possibility that 
     insurers will design health-care packages that offer no 
     mental-health care at all--a sneaky and pernicious way to 
     skirt the parity requirement altogether.
       But why worry about such things now? Bush has become a 
     believer. Now perhaps he'll exercise a sliver of 
     compassionate conservatism and lead the fight against 
     weakening the modest mental-health parity bill. So voters 
     must hope--and insist.
                                  ____


                 [From the New York Times, May 1, 2002]

                      Toward Mental Health Parity

       President Bush said some encouraging words this week about 
     the need for a health care system that will treat mental 
     illness with the same urgency as physical illness. The 
     president seemed to suggest that health insurance should 
     cover mental problems on the same terms as other medical 
     problems. If the president is serious about this issue, he 
     will need to lean on recalcitrant House Republicans, the 
     chief impediment to reform, to pass a bill elevating mental 
     health coverage to a par with medical and surgical coverage.
       Congress took the first step toward this goal in 1996 when 
     it passed legislation that prevented private plans that offer 
     mental health coverage from setting annual or lifetime limits 
     that are lower than those set for other illnesses. But the 
     law left a loophole that allowed companies to require much 
     higher deductibles and copayments for mental health 
     treatments than for other diseases. So a new bill--pioneered 
     by Senators

[[Page S3587]]

     Pete Domenici, Republican of New Mexico, and Paul Wellstone, 
     Democrat of Minnesota--is now pending that would require 
     parity in all terms, including deductibles, co-insurance and 
     duration of treatment.
       Although Mr. Bush shared the stage in Albuquerque with 
     Senator Domenici, a longtime supporter of full mental health 
     parity, he did not endorse the senator's progressive and 
     expansive bill, which would require parity for more than 200 
     mental health conditions listed in the chief diagnostic 
     manual when they cause clinically significant impairment. In 
     one comment, Mr. Bush seemed to be seeking ``full mental 
     health parity,'' but in another he talked only of putting 
     ``serious mental disease'' on a par with other diseases. He 
     also called it ``critical'' that the move toward parity not 
     run up the cost of health care significantly.
       The chief arguments shaping up in Congress involve the 
     potential cost of upgraded mental health coverage and the 
     appropriate range of mental illness to be covered. The 
     Congressional Budget Office estimated last year that the 
     Domenici-Wellstone bill would drive up premiums by about 1 
     percent, a cost that seems bearable given the importance of 
     treating mental illness and removing the stigma attached to 
     it. The health industry suspects that costs may rise faster 
     and deplores any added cost to a system already under 
     financial strain. But surely there are compromises that would 
     install mental health parity as the norm but allow health 
     plans to abandon parity if their psychiatric costs rose 
     beyond a reasonable level. Me. Bush needs to follow his 
     rhetoric with some hard bargaining to get a bill passed by 
     Congress this year.

  Mr. WELLSTONE. Both editorials are strong. They thank the President 
and my partner in this effort, Senator Domenici, for their fine work. 
Both point out that we need to make sure we have full mental health 
parity. We need to end the discrimination and make sure our loved ones 
and other families are provided with the treatment they need. That is 
not happening today. This would be a huge civil rights bill that would 
end discrimination and get much more coverage to people.
  I recommend to every colleague the three-part series in the New York 
Times, front page. I cannot even read it, it is so powerful and so 
painful with regard to what is happening to those put in homes for 
mental health coverage. Because of the coverage they are getting, there 
will be a criminal investigation. People have taken their lives by 
jumping out of windows because of no supervision. The staff is 
underpaid and poorly trained and does not know how to provide the 
pharmacological coverage.
  People live in the homes which are supposed to be community-based 
care, and there is absolutely no treatment, no help. These are people 
who do not have money. They are not capable of being a political force. 
My God, they live under the most wretched conditions. This should not 
happen in the United States of America.
  It is a powerful series. I have never seen a greater contribution 
than what the New York Times has done on the front-page series.

                          ____________________