[Congressional Record Volume 154, Number 42 (Wednesday, March 12, 2008)]
[Extensions of Remarks]
[Pages E359-E360]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     PAUL WELLSTONE MENTAL HEALTH AND ADDICTION EQUITY ACT OF 2007

                                 ______
                                 

                               speech of

                          HON. JOHN D. DINGELL

                              of michigan

                    in the house of representatives

                        Wednesday, March 5, 2008

  Mr. DINGELL. Mr. Speaker, I would ask that the following letters of 
support for H.R. 1424, the Paul WeIIstone Mental Health and Addiction 
Equity Act of 2008, be submitted for the record on the floor debate on 
this bill.

                                     National Association of State


                              Mental Health Program Directors,

                                Alexandria, VA, February 29, 2008.
     Hon. Patrick J. Kennedy,
     Hon. Jim Ramstad,
     House of Representatives,
     Washington, DC.
       Dear Representatives Kennedy and Ramstad: On behalf of the 
     National Association of State Mental Health Program Directors 
     (NASMHPD). I am writing to offer our strong support for H.R. 
     1424, the Paul Wellstone Mental Health and Addiction Equity 
     Act of 2007. NASMHPD represents state and territorial mental 
     health commissioners/directors and their agencies that 
     provide public mental health services to over 6 million 
     people annually. Our members manage community-based systems 
     of care as well as inpatient care in state psychiatric 
     hospitals for individuals with serious mental illness.
       It has been over ten years since the Congress passed the 
     Mental Health Parity Act, which prohibited annual and 
     lifetime dollar limits for mental health care. This small but 
     symbolically important first step left much work to be done; 
     it is now the time to fill remaining gaps by prohibiting 
     treatment limitations and eliminating inequitable financial 
     requirements. An ever-growing body of research, advanced 
     especially during and since the 1990-2000 Decade of the 
     Brain, demonstrates that mental and behavioral disorders are 
     brain disorders and benefit in the same way as other physical 
     disorders from advances in science. Scientific knowledge of 
     mental illness has removed all justification for the wide-
     spread difference in insurance coverage for mental health 
     benefits.
       An October 2006 NASMHPD study describes an alarming finding 
     that people with mental illness experience twenty-five years 
     of lost life. This is an unconscionable situation that 
     demands immediate action, for all adults and children with 
     mental illness who now

[[Page E360]]

     face such terrible odds against living a long and healthy 
     life. The harsh reality of poor health for those with mental 
     illness requires new approaches to integrate mental health 
     and general health. Enacting a strong mental health parity 
     law has the potential to measurably improve the health status 
     of individuals with mental illness who suffer other dire 
     health consequences.
       The states' mental health directors commend you for your 
     leadership on this critical national priority. We are pleased 
     to add our voice to the growing chorus of support that was so 
     clearly demonstrated during your highly successful ``Equity 
     Campaign Tour'' along with the 273 co-sponsors of H.R. 1424.
           Sincerely,
                                                 Robert W. Glover,
                                               Executive Director.


                             American Psychiatric Association,

                                     Arlington, VA, March 5, 2008.
       Dear Representative: I am writing on behalf of the American 
     Psychiatric Association (APA), the medical specialty 
     representing more than 38,000 psychiatric physicians 
     nationwide, and particularly on behalf of our patients and 
     their families, to urge you to vote for passage of mental 
     health ``parity'' legislation (H.R. 1424) on March 5, and to 
     oppose any weakening amendments and/or motions to recommit.
       Mental illnesses have a devastating impact on millions of 
     Americans every day. The good news is that treatment works, 
     but too many insurance plans impose discriminatory cost-
     sharing and treatment limits on mental health care that are 
     not required for treatment of any other illnesses. For nearly 
     a decade, the Federal Employees Benefits program has required 
     insurers to provide parity coverage for mental health care. 
     Research has shown that the parity requirement has not led to 
     any significant cost increase for federal employees 
     (including Members of Congress and their staff). Surely the 
     public at large deserves the same coverage?
       Opponents of the House bill are circulating outrageous and 
     false claims about what the House bill does. I am attaching a 
     brief fact sheet that sets the record straight. Please feel 
     free to share this with your House colleagues.
       The members of the APA have been pleased to work with the 
     House Blue Dogs over the years, and look forward to a 
     productive relationship in the years ahead. Please reject the 
     blatant disinformation being circulated by parity opponents 
     and vote for passage of H.R. 1424. It is long past time for 
     Congress to act.
       Thank you for your support.
           Sincerely,
                                            Carolyn B. Robinowitz,
                                                        President.

 American Psychiatric Association Response to Controversy About DSM-IV 
                  and Mental Health Parity--March 2008

       Business and insurance opposition to passage of H.R. 1424 
     in part involves opposition to the use of the Diagnostic and 
     Statistical Manual of Mental Disorders (DSM-IV) to define 
     those conditions that must be covered by health plans under 
     the terms of the bill. Let's look at a few of these claims:
       DSM-IV obligates employers to cover jet lag, caffeine 
     intoxication, and similar conditions:
       Fact: This is nonsense. These claims typically refer to so-
     called ``V Codes.'' These are not DSM diagnoses, The V Codes 
     are developed by the World Health Organization for the 
     International Classification of Diseases (or ICD), not by the 
     APA for the DSM. They are listed in DSM as a courtesy to 
     facilitate coding and cross-walking between DSM and the ICD, 
     and they are intended to allow clinicians to identify the 
     types of non-diagnostic problems that are brought to their 
     attention.
       Because it is ``so broad,'' using DSM to set baseline 
     coverage will force insurers and employers to pay for 
     treatments for the most minor of conditions.
       Fact: This argument is based on the false premise that 
     diagnosis and treatment are one and the same. This is 
     absolutely false. Simply because a diagnosis is made does not 
     obligate insurers to pay for treatment, and nothing in H.R. 
     1424 changes that fact. Treatment would still be subject to 
     the same medical necessity decision-making and utilization 
     review that is in effect today. The appropriate treatment for 
     jet lag would almost certainly be ``get some sleep.'' Members 
     of the House should demand that employers who argue about jet 
     lag and caffeine intoxication provide data showing they have 
     incurred any appreciable costs because they have been forced 
     to pay for treatment.
       DSM-IV will codify a treatment mandate.
       Fact: False. This claim confuses diagnosis with treatment. 
     Once again, DSM-IV is not a treatment mandate, it is a 
     diagnostic tool. In fact, employers and insurers don't want 
     you to know that they use DSM every day to limit and in some 
     cases deny treatment under terms of medical necessity.
       The American Psychiatric Association has a vested interest 
     in having DSM-IV written into federal law, creating an 
     improper conflict of interest.
       Fact: DSM-IV is widely recognized as the leading and 
     internationally authoritative text for the diagnosis of 
     mental illness. It is the product of exhaustive research and 
     deliberation over a six-year period involving more than 1,000 
     individuals and numerous professional organizations, as well 
     as agencies of the Federal Government. As a result, DSM-IV is 
     referenced and has legal standing in more than 900 federal 
     and state laws and regulations. The major legal reason why 
     states and the Federal Government have used DSM-IV instead of 
     ICD-9-CM is to insist on a higher and more precise standard 
     for defining a mental disorder. Are employers and insurers 
     proposing to ban any references to CPT-Codes in federal law, 
     or use of ICD-9-CM codes for billing purposes? Of course not. 
     Why is DSM-IV any different?
       The House of Representatives is poised to take a truly 
     historic step toward ending insurance discrimination against 
     Americans seeking help for mental illnesses, including 
     substance-related disorders. Please do not allow the 
     deliberate distortions and outright falsehoods about DSM-IV 
     asserted by business and insurance groups to influence your 
     vote. The 38,000 psychiatric physician members of the 
     American Psychiatric Association urge you vote for passage of 
     H.R. 1424.
       For additional information, please contact the APA's 
     Department of Government Relations.
                                    National Council on Alcoholism


                                    and Drug Dependence, Inc.,

                                      New York, NY, March 3, 2008.
     Re support for HR-1424 the Paul Wellstone Mental Health and 
         Addiction Equity Act.

     Hon. Nancy Pelosi,
     Speaker of the House of Representatives,
     Washington, DC.
     Hon. John Boehner,
     Republican Leader, House of Representatives,
     Washington, DC.
       Dear Speaker Pelosi and Leader Boehner: On behalf of the 
     National Council on Alcoholism and Drug Dependence, Inc. 
     (NCADD) and our National Network of Affiliates, I am writing 
     to express our support for HR 1424, the Paul Wellstone Mental 
     Health and Addiction Equity Act. HR-1424 would prohibit 
     insurance discrimination against 80 million Americans 
     suffering from addiction and mental illness! Pass HR-1424 
     without any amendments that would weaken the bill and oppose 
     any effort to substitute S-558. A vote for S-558 is a vote 
     against addiction and mental health coverage that would 
     count!
       The lives of millions of Americans are at stake. Last year, 
     over 650,000 individuals and family members contacted NCADD 
     seeking help for themselves or a family member! The lack of 
     access to alcoholism and addiction specific treatment through 
     insurance results in continued alcohol/drug use and insurance 
     pays a fortune to treat all of the physical symptoms that 
     result from alcoholism and addiction, accidents, gastritis, 
     broken arms/legs, cirrhosis, etc. The financial cost of 
     addiction and mental health problems is staggering. And, the 
     best way to reduce those costs is by providing access to 
     treatment! Each year, 1.3 billion work days are lost due to 
     mental disorders, more than arthritis, stroke, heart attack 
     and cancer combined. Moreover, workers with untreated 
     depression cost their employers $31 billion a year in lost 
     productivity and workers with untreated alcoholism cost their 
     employers $135 billion in lost productivity each year.
       The time to end the insurance discrimination faced by those 
     with addiction and mental health issues is now! The Paul 
     Wellstone Mental Health and Addiction Equity Act (H.R. 1424), 
     introduced by Representatives Patrick Kennedy (D-RI) and Jim 
     Ramstad (R-MN), has the support of the majority of the House 
     with 273 cosponsors. The bill has been favorably reported by 
     the Ways and Means, Energy and Commerce and Education and 
     Labor Committees. Lastly, fourteen Congressional field 
     hearings in 2007 clearly documented the need for equity in 
     health plans for the treatment of addiction and mental 
     illness, parity is a priority and it must be passed now!
       Because of the critical nature of this legislation, we urge 
     you to vote in support of HR 1424. On behalf of those who 
     will benefit from access to life-saving treatment, thank you 
     for support!
           Sincerely,
                                                Robert J. Lindsey,
     President/CEO.

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