Show #382 Airing Sunday, 4/8/07
If you suffer from Parkinson’s or heart disease, your health insurance generally covers you. You may get a million dollars of benefits a year. But with severe depression, schizophrenia or some other mental illness, you might be limited to $550 of care. That’s right, millions of Ohioans with mental disorders have been discriminated against by their insurance companies. But this year, all that has changed, thanks in a big measure to Ohio State Senator Robert Spada. So we’ve asked Senator Spada to join us in our kitchen to explain. Welcome.
Question: How were people with mental illnesses discriminated against before this year?
Answer: Insurers generally covered physical illness, such as cancer and heart disease. Maximum benefits often run $1million/year. But people with biologically based brain disorders were not treated the same. Their benefits often would be cut off at $550.
Question: Tell us about the new mental health parity law.
Answer: Mental Health Parity was signed into law at the end of last year. Mental Health Parity means that all health insuring corporations operating in Ohio must offer coverage for services for biologically based brain disorders on par with other coverage.
What this means is that we will no longer allow discrimination in group health care policies toward biologically based illnesses of the brain.
Over 2 million Ohioans have a biological illness of the brain. With mental health parity, instead of having their benefits cut off after they exceeded their threshold for mental health services for the year - which by prior law could be no less than $550 - Ohioans now have coverage for the care they need. To put it in other words, they will be treated on par as someone who has cancer, heart disease, or some other major physical health illness.
This new law is important because people with mental illness often find themselves in need of treatment but without the means to pay for it, even if they have health insurance. Their illnesses can force workers and their families deeply into debt to pay hospital and other related bills that insurance won't cover. Other people avoid treatment altogether, and that too has its costs, including expensive emergency hospitalizations, loss of employment and relationships, and even worse suicide.
Each year, severe mental illness affects more than half a million adults and children in Ohio. Mental illnesses are real medical conditions - just like heart disease and cancer - that can be treated as effectively as physical diseases. With proper diagnosis and treatment, covered workers stay employed. Employed people purchase more goods and services and rely less on publicly funded programs. That means more consumers able to purchase goods and services supplied by Ohio's businesses, and fewer tax dollars needed to fund hospitals, prisons, and homeless programs.
Question: I understand this law had bipartisan support?
Answer: Yes. I worked closely with Senator Eric Fingerhut and others.
Question: What types of mental illnesses are covered under this new law?
Answer: 7 biologically based mental illnesses are covered under mental health parity. These include:
- schizophrenia
- schizoaffective disorder
- major depressive disorder
- bipolar disorder
- paranoia
- obsessive-compulsive disorder
- and panic disorder.
Here's an example of how mental health parity can help: Parkinson's disease occurs when there is not enough dopamine transmission in the brain. This disease is treated by turning up dopamine transmission through the use of medications. Basic health-care medical insurance will cover all standard treatments of this major brain disorder.
On the other hand, too much dopamine results in schizophrenia. Before mental health parity, treatment could cease after $550 dollars of medication each year. But now, the patient would be covered as equally as if he/she had Parkinson's disease.
Question: Do treatments for mental illnesses work?
Answer: Treatment does work. The success rate for bipolar disorder is approximately 80%, for major depression, 70%, and for schizophrenia, 60%.
Question: What does this new law mean especially for seniors?
There is nothing specifically in the law that addresses seniors, but anyone who is covered by private health insurance who has one of the seven biologically based mental illnesses covered under the new law should take the time to learn if their plan will be impacted. It is important to note, however, that even if a senior with mental illness does not directly benefit from the new law, he or she will certainly benefit indirectly. Passage of the mental health parity bill was a huge step forward in Ohio in the movement toward eliminating the stigma of mental illness. Because stigma interferes on so many levels with good treatment, this is a big step forward for all Ohioans. Also, seniors with loved ones who will be covered under the new law will likely see some relief in their care giving responsibilities either now or in the future.
With regard to seniors and mental health disorders, it is important that seniors educate themselves about the signs of depression. Approximately 1 out of every 5 seniors experience some form of mental health disorder, and 20 percent of all suicides are committed by adults ages 65 and older. For older adults, depression often coexists with other medical illnesses and disabilities so that doctors and families may miss the depression diagnosis or mistake it dementia.
Recognizing depression in the elderly is not always easy. It often is difficult for the depressed elder to describe how he or she is feeling. In addition, the current population of older Americans came of age at a time when depression was not understood to be a biological disorder and medical illness. Therefore, some elderly fear being labeled "crazy," or worry that their illness will be seen as a character weakness.
The depressed person or their family members may think that a change in mood is simply "a passing mood," and the person should just "snap out of it." But someone suffering from depression can not just "get over it." Depression is a medical illness that must be diagnosed and treated by trained professionals. When it is properly diagnosed and treated, more than 80 percent of those suffering from depression recover and return to their normal lives. The most common symptoms of late-life depression include:
- persistent sadness (lasting two weeks or more)
- feeling slowed down
- excessive worries about finances and health problems
- frequent tearfulness
- feeling worthless or helpless
- weight changes
- pacing and fidgeting
- difficulty sleeping
- difficulty concentrating
- physical symptoms such as pain or gastrointestinal problems
Question: Does it go far enough?
Answer: Some organizations in Ohio did not support S.B. 116 because they believed the bill did not go far enough. Some states that have passed insurance parity bills include all mental health disorders, not just the most severe. Also, many states have included alcohol and drug addiction treatment services in their bills. Over the years, Ohio’s bill was modified to address the concerns of interest groups who opposed a broader bill. These interest groups included insurance companies and small businesses, which expressed the concern that the bill would result in increased costs. To address this issue, the bill includes a provision which allows health insurers to “opt out” of this new mandate if they can demonstrate that after providing mental health coverage for one year that their premiums have increased by more than 1% as a result of this additional coverage.
Question: How can our viewers learn more about the issue?
Answer: You can call NAMI Greater Cleveland or the Cuyahoga County Community Mental Health Board.
Ohio has entered a new era in treating mental illness, and Senator Robert Spada deserves a big thank you. So Bob, thank you. To learn more about your rights under the new law, contact NAMI or the Cuyahoga County Community Mental Health Board.
