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Right time for mental health parity


Given that untreated mental illnesses cost U.S. businesses hundreds of billions of dollars annually in lost productivity, corporate opposition to mental-health-parity legislation is a little dizzying.

Opponents argue that by forcing insurers to cover treatment for mental illnesses that are biological in nature, the health-insurance premiums of all Iowans will increase. Never mind the primary rule of insurance economics – that with a smaller pool comes greater risk, with greater risk comes higher costs and the best way to minimize risk is to increase the size of the pool and spread the costs evenly. There are other numbers that are equally dizzying:

One in five Americans suffers from a diagnosable and treatable mental illness each year, but many delay treatment because their insurance companies won’t cover it. Suicide is the eighth-leading cause of death in the nation, and the second-leading cause of death among young people aged 15-24 in nine states, including Iowa, and 90 percent of those who took their own lives had been diagnosed with a treatable mental illness. And it’s impossible to calculate the intangible costs to families, co-workers and friends – in frayed relationships and other human sufferings that result from mental illnesses going untreated.

The Legislature has tiptoed around this issue for years. There’s some small measure of consolation in that; lawmakers can benefit from other states’ experience. For example, insurance costs did not appreciably increase in Vermont, which has some of the most comprehensive mental-health-parity laws in the country. A study by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration found the legislation resulted in a 4 percent increase in mental health spending by Blue Cross Blue Shield of Vermont, which averaged to an increase of 19 cents per policyholder per month. The other health plan reviewed in the study, offered by Kaiser/CHP, had a 9 percent decrease in mental-health costs after Vermont passed the legislation.

The sky hardly seems to be falling on the insurers of Vermont – and that’s after the passage of legislation far more comprehensive than the measure proposed in Iowa. Here, the bill would require insurers to cover the costs of treatment for “biological” mental illnesses, but not for substance abuse, eating disorders and certain ailments unique to children.

That it is itself discriminatory is a major flaw in legislation that aims to stop discrimination in health-care coverage, but it’s a middle-ground approach business interests ought to be comfortable supporting.

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