Pubdate: 3 Mar 1999
Source: San Jose Mercury News (CA)
Copyright: 1999 Mercury Center
Contact:  http://www.sjmercury.com/
Author: David L. Breithaupt

DON'T ASK ADDICTS TO WAIT ANY LONGER FOR FAIR TREATMENT

ASSEMBLY Bill 88 should not be endorsed in its present form. It is referred
to as a parity bill by its sponsor, Helen Thomson, and by the California
Psychiatric Association. This is a misnomer. True parity should include
treatment for alcoholism and other addictive disorders.

I'm told by AB 88 supporters that only by an incremental approach can we
one day have true parity. Addicts and their families are being told, ``It's
not your turn.''

Treaters of mental disorders and of addictive disorders should not be
competitors for treatment dollars. Taxpayers and industry save money by
providing treatment for addictive disorders and mental illness. The
presumed competition for dollars is analogous to the mid-19th century
abolitionists' argument that ``the woman question'' was putting their own
cause at risk. Feminists were told to step back and lower their voices
because the nation wasn't ready to both free the slaves and provide civil
rights for women. It took another 70 years to pass the 19th Amendment.

According to the U.S. Dept of Health and Human Services, the average
premium increase for full mental health and substance abuse coverage (March
1988) was 3.6 percent. Addiction coverage accounted for two tenths of 1
percent of the total! If it is not a cost problem, then why not add
treatment of addictive disorders to AB 88?

AB 88 provides coverage for ``severe mental illnesses.'' All are supposedly
defined as biologically based and often treatable by medication. The list
limits psychiatrists; and it effectively eliminates treatment of mental
illness by psychologists, and support services of marriage and family
counselors. Psychiatrists trained and certified to treat addictive
disorders oppose this bill and point out that many of the ``approved''
illnesses have a questionable biological basis. Addiction, on the other
hand, they say, is easily explained on a biologic-physiologic basis.
Certainly physical tolerance and withdrawal syndromes are biological brain
disorders.

We should follow the lead of Vermont, the only state that has a true parity
law. There are no addiction exclusions, no authorized list of mental
illnesses, no lifetime cap, no exclusion for self-insured employers or
those with fewer than 50 employees. The cost to subscribers is $3.40 per
month per insured household. If employers pay, the cost is 2.5 cents per
hour per employee.

The time for real parity is now. The task is to stretch our health benefit
dollars. We can no longer bear the cost of not treating addiction. The cost
of treating pancreatitis, cirrhosis, traumatic injury, battered spouses,
and sexually abused children is too high.

Dr. David L. Breithaupt is a semi-retired San Jose physician. 
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