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Greater Access to Treatment Needed

As July Fourth approaches and we prepare to celebrate our country’s founding, it is a good time to ask ourselves whether we are fulfilling the ideals on which this nation was built. There is no more fundamental American principle than ensuring that all people have a chance to pursue their God-given potential. But for tens of millions of Americans living with mental illnesses and addictions, that promise is elusive, blocked by treatable diseases left untreated.

Most health plans unfortunately erect barriers to mental health and addiction treatment. People seeking treatment for these diseases face higher co-payments and deductibles and arbitrary limits on the number of office visits or inpatient days covered. They pay the same premiums as everybody else, but when they get sick their insurance isn’t there for them. Earlier this year, we crisscrossed the country holding informal field hearings on mental health and addiction, and we listened to hundreds of Americans who want Congress to help provide greater access to treatment. (To read our report on these hearings, “Ending Insurance Discrimination: Fairness and Equality for Americans with Mental Illnesses and Addictions,” visit

During our travels, we heard from consumers and providers, police chiefs, judges, business leaders, insurance executives, hospital presidents and public health officials. All of them understand that treating people with mental illness and addiction is crucial to addressing many problems in health care, education, criminal justice, homelessness, veterans’ health care and other areas. But what it’s really about is the American dream.

Ending insurance discrimination is about whether our nation lives up to the ideals of the Declaration of Independence and the Constitution, promising every person the chance to reach his or her God-given potential. It’s about people like Amy Smith from Denver. She told us that when she meets people she knew 25 years ago, they are stunned she is still alive.

Amy was in and out of jail and emergency rooms, unable to connect with other people, muttering to herself on the street and unemployed. For 45 years, she says, she was a drain on society. Four decades of her life lost. Then she finally got the treatment she needed. Now she’s healthy and happy and holding down a good job.

Ending insurance discrimination is about people like Kevin Hines. Kevin is an outgoing, effusive, gregarious young man who told our forum in Palo Alto, Calif., about jumping off the Golden Gate Bridge in 2002. Unlike most jumpers, Kevin miraculously survived, and now he’s getting married this summer. How many others who didn’t survive that fall could have found happiness and success if they had help?

The American dream should not be rationed by diagnosis. That’s why Congress must pass the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424) to end insurance discrimination against Americans living with mental illnesses and addictions. Nobody would dream of telling cardiac or cancer patients or diabetics that their diseases are just too expensive to cover fully. It would be unconscionable, just as it is to restrict coverage of chronic brain diseases.

Ending insurance discrimination is not only the right thing to do; it’s also the smart thing to do. We know from experience that improving mental health and addiction benefits can actually reduce health care costs by avoiding unnecessary hospitalizations, controlling chronic physical diseases and reducing emergency room visits. It improves productivity in the workplace and cuts down on law enforcement problems.

We heard supportive testimony from law enforcement leaders from Providence, R.I., Dallas, Los Angeles and elsewhere. That’s why a business executive in Denver called it a “no-brainer,” and the CEO of Rhode Island’s largest insurer said restricting access to mental health and addiction treatment is “bad medicine, bad law and bad insurance.” And state legislators and public health officials throughout the country called on us to forcefully pass a strong bill to end insurance discrimination.

We know that equalizing benefits is cost-effective. In 2001, the federal government ended insurance discrimination for the 9 million members of the Federal Employees Health Benefit Plan, including Members of Congress. A detailed, peer-reviewed analysis found that the policy change did not increase mental health and addiction treatment costs.

Indeed, it’s the status quo that is unaffordable. Our nation cannot afford the $105 billion annually in lost productivity because of mental illness or the $135 billion attributable to alcohol and drug addiction. We cannot afford the 30,000 victims of suicide each year, or the complications of chronic physical diseases such as diabetes and heart disease running rampant in individuals with mental illnesses, killing them on average 25 years earlier. We can’t afford to turn our backs on our veterans who have incurred post-traumatic stress disorder in our defense, or stand by as half of emotionally disturbed special education students drop out of school. Nor can we continue to pay $100,000 per year incarcerating individuals who could be healthy and productive members of society for the price of treatment.

Access to treatment is not just another public policy issue. It’s a matter of life or death for 54 million Americans with mental illness and 26 million suffering from chemical addiction. As Amy Smith plaintively noted: “I would have been able to pursue my dreams for my life, which were things like driving a car, or holding down a real job, or getting married, or volunteering in the community, any of those things … I think my life would have been a lot different if I had had those services a lot earlier.”

Like Amy Smith, we are living examples that treatment works and recovery is possible. We believe all Americans deserve the same chance.

Reps. Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.) are the lead sponsors of the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424).

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