I want to trust insurance companies. I want to believe that they understand the connection between mental and physical health and that health care costs would drop if we treated both equally and fairly. I want to believe that insurance companies put people before profits and that they play by the rules. But they don’t because there are no rules.

It’s been four years since President George Bush signed the Paul Wellstone & Pete Domenici Mental Health Parity and Addiction Equity Act  and still we have no rules. Why is it taking so long for regulators to write rules requiring insurance companies to provide equal coverage for mental and physical health? How hard can it be to draft regulations that ban separate co-pays or higher deductibles for mental health treatment and medications? Come on. Four years? Herman Melville churned out Moby Dick in less than four years and I almost read it in four years.

Getting the Parity Act passed was a monumental accomplishment that capped a 12 year battle between parity advocates, such as former Congressman Patrick Kennedy, D-Rhode Island, and former Senator Jim Ramstad, R-Minn and the insurance industry. It was the greatest medical civil rights victory of our generation. The law would finally ensure that people with mental illnesses would get the care they need and that mental illnesses would finally be accepted as legitimate medical conditions.  That has not happened.

Why?

I’ve got a bad feeling about Senate Bill 3562 introduced by Senator Bernie Sanders (I-VT) on September 19. Like me, you may have missed the birth S 3526, which was introduced to “reauthorize and improve the Older Americans Act of 1965, and for other purposes.” I have been slightly preoccupied with the Detroit Tigers and Derek Jeter’s busted ankle.

Besides, who could possibly oppose a bill to reauthorize the improve the  Older American’s Act of 1965, which created the Administration on Aging and all kinds of entitlement programs for the elderly? I began wondering, too,  about the phrase “and for other purposes.” What does THAT mean? So, I read the proposed bill and noticed that when it comes to funding mental health programs for the elderly, someone had decided to preface all services for seniors – including mental health services -  with the phrase “evidence-based.” For example,

(E) in paragraph (23), by striking ‘‘mental health services’’ and inserting ‘‘evidence-based mental health, chronic condition self-care management, elder abuse, neglect, and exploitation prevention, and falls prevention services’’;

Who could possibly oppose “evidence-based” services? Using our tax-dollars to pay for services with proven track records is a good thing, right?