Health Insurance: The Issues, Pre-Election

There is much public discussion in the presidential debates (and in the press and on candidate's web pages) surrounding the best way to address American healthcare and insurance accessibility. While I believe it is a fair statement that all Americans agree that health insurance coverage should be assessable to everyone, how each presidential candidate would like to resolve this matter is where the differences reside in ideology vs. economics vs. reform. Fully understanding the choices in front of us is important.

But aren't such overriding discussions on health insurance access putting the cart before the horse? There is still much to be done that can be done for health insurance coverage and access between now and the November 2008 election.

In the meantime - in the next eleven months prior to the election - my question is: What are policy makers actively doing now to move forward the health insurance access policy issues currently on the legislative docket? And for that matter, while the senators and representatives campaign, why are some not showing up to vote and/or remain involved in such debates on the floor of their respective legislatures? I find this disconcerting.

My questions arise because an important issue in the mental health community is starting to get lost, namely the mental health parity bill-the bill that requires health insurance companies to cover treatment for mental illnesses the same as physical illnesses. This bill is not yet law. The fact remains that there is still discrimination within the current health insurance industry regarding mental illness health coverage. If equal access to health insurance by all Americans is important, doesn't this parity issue fall under the same category of equal access?

The Senate passed their version of the mental health parity bill in September 2007. This was indeed cause for celebration. The House of Representatives, however, is still hammering out their version of the bill. The President has publicly stated he is open to the passage of such a parity bill, and the good news is that there is widespread agreement on this issue by policy makers on both sides of the aisle. The differences lie in the details.

The Senate bill is less restrictive and the House bill defines which mental illnesses should be included (such as substance abuse and PTSD, which are important issues, particularly for our returning veterans). Only when the House bill gets passed can the subcommittees from both legislative arms meet to create a "compromise bill" that will be presented for passage before the House and Senate (again) before it may be given to the President for signage into law.

It takes a long time for an idea to become a bill, and then for that bill to become law. Even with the House and Senate and the President in agreement, bills do not get approved quickly into law, never mind the date slated for implementation, nor the exact content of what will get implemented.