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During an interview last week with Steve Inskeep on NPR , British Prime Minister Tony Blair said something that resonated with me. He said,

[T]he Labour party should be the marriage of aspiration and compassion. That there's nothing wrong with wanting the best for yourself and your family, it's just that you don't want to exclude that possibility for other families, too.

There’s a lesson in that statement for North Carolinians.

Yesterday during the Crucial Conversation luncheon about the state of North Carolina’s mental health system, I listened as numerous parents describe their personal ordeals trying to find mental health or developmental services for their children. These were parents, who like me, only wanted to provide what was best for their children. The mental health parity bill would help many families whose only aspiration is providing care for their family members. 

I hope, as state, we can find the compassion to put in place the systems and services so that all families can have an opportunity to thrive.

My name is Sarah B. and I am a survivor of mental illness.  Living with mental illness is like riding a roller coaster.  Filled with ups and downs, twists and turns, life is filled with uncertainty.  Part of the roller coaster ride relates to obtaining, receiving and paying for insurance coverage and services for mental health.

There is the incident of a young man, age 17 who was hospitalized.  The doctor recommended psychiatric in-patient care.  This young man’s insurance company refused to pay, telling the family to seek outpatient care first.  This response from the insurance company was given in spite the Director of the outpatient facility also recommended in-patient hospitalization.  Outpatient care was tried and failed.  The young man ended up being incarcerated.

Another story is that of a young mother, age 38 who became disabled.  She sought health insurance and the premiums were either too expensive or she was denied coverage because of her diagnosis.  Eventually she found insurance coverage with out-of-pocket expenses to be $6,000-$8,000 annually.  Obtaining insurance coverage did not reduce the problems she encountered, as many health care providers would not accept the coverage.  These incidences increased this young mother’s anxiety and depression, causing her more severe symptoms. 

I became disabled before the age of 65 and had insurance coverage with my husband’s employer.  When that coverage ended, I had to seek supplemental insurance.  The first thing I encountered was the cost of premiums which were triple for individuals below age 65 compared to individuals age 65 and older for the same coverage.  An example of the budget restraints placed on me is the premium quoted was $350 per month.  At that time I had income of $800 per month.  The cost of the insurance was approximately 44% of my income.  Who can afford that? 

Before reaching age 65, I found a policy that combined Medicare and Medicare supplement at a minimum cost.  In that plan, the costs for mental health services were covered at 50%.  Costs for physical problems did not and do not have this limitation.

Today at age 65, I maintain coverage for Medicare and Medicare supplement.  Mental health care is still covered at 50%.  Co-pays for mental health services are set higher than physical health services.  For example:

          

Cost of MH visit                     $70                            PCP Visit         $167

            Co-Pay                      40                             Co-Pay               15

            Co-Pay =                57% MH Visit                 Co-Pay =          9% PCP Visit

 

If one compared a PCP visit at the same rate as a MH visit the cost of co-pay is 21% for the PCP visit vs. 57% for the MH visit.

Inequity in coverage for mental health keeps people with mental illness from seeking the treatment they need.  Higher costs of insurance deter individuals getting the protection they need.  Difference in co-pays cause hardship for those on limited income.  A more equitable way would allow those on disability to afford the coverage they need, seek available services at an affordable cost, and reduce hospitalization.

Regarding hospitalization, recall the story of the young man who was denied insurance coverage because the insurance overruled the recommendations of a doctor and Director of an outpatient facility?  On February 9, 2006, my doctor referred me to a psychiatric inpatient stay for a minimum of five days.  The insurance company I had a policy with denied that stay, allowing only for a 23-hour observation.  If this had been a person with diabetes, cancer or heart disease, the denial would not have been made.

Individuals with mental illness are no different than you.  They simply are people who have more obstacles to overcome than you.

Last week progressives in three states passed legislation that addresses living wages, state EITC and mental health parity.

We can do itMaryland approved the first-in-the-nation living wage bill. HB430, sponsored by Del. Herman Taylor, requires state contractors to pay employees a living wage. The bill creates a two-tier system: wages in urban areas will be at least $11.30 per hour; wages in rural areas will be at least $8.50 per hour. Maryland’s minimum wage is the same as North Carolina’s, $6.15 per hour.

New Mexico’s Governor Bill Richardson signed a bill creating a state Earned Income Tax Credit (EITC) worth 8% of the federal EITC. HB 436 introduced by Rep. Ben Lujan will help low-income working families in New Mexico.

Washington Governor Christine Gregoire signed a bill broadening the state’s mental health parity law. The bill, HB1460 sponsored by Rep. Shay Schual-Berke, will require health insurers to offer mental health coverage that is equitable to medical coverage to small businesses and individuals. A 2005 mental health parity law already covered employees of large companies.

News of these bills passed by other states leaves me wondering, if they can do it, why can’t North Carolina?

This session, legislators are considering HB51, which provides a 10% of the federal EITC, as well as a mental health parity bill (SB1434). These bills would go a long way to improving life for half a million North Carolina families who are struggling financially. Other states are proving that it is not too costly to provide living wages, Earned Income Tax Credits or mental health parity. We can do it too!