AACP Newsletter, Volume 7,
Number 2, Spring 1993
President’s Column:
The Politics of Parity
There are compelling arguments for parity of payment, however, there has been limited movement in this direction. Knowing that parity will apply to some mental disorders and that others will be excluded, the APA has only recently made a conditional endorsement of parity legislation.
As a community psychiatrist I cannot be comfortable holding seriously mentally ill patients hostage to the fears that services to other populations might be adversely affected by parity statutes. While I strongly believe that all psychiatric illnesses should be covered by third party payers, it is clear to me that eliminating the inequities in coverage for the seriously mentally ill is the most compelling action needed at this time. Politics involves compromise, and one rarely can get all that one wants.
In the past, slavery was acceptable to many, and limiting voting rights to males was the rule. Much effort was required to change those practices. Systematic financial bias against mental illness will ultimately meet the same fate as these other societal practices that today seem unconscionable. As my recent fortune cookie succinctly described this situation, “one generation’s philosophy is the next generation’s common sense.”
In Rhode Island, legislation is being introduced to ensure parity of coverage for specified serious mental illness. This legislation is being promoted by the Alliance for the Mentally Ill (AMI), and the Rhode Island Psychiatric Association will support it. The largest managed care firm in Rhode Island also favors this bill. Of course the fate of this initiative is far from certain.
Should this type of legislation be introduced in your state? I think so. It will probably fare better if the impetus comes from AMI rather than a professional organization with an obvious vested financial interest. However, the more parties involved in a coalition supporting a bill, the better the chance for passage. Someone has to take the initiative to get things going. Maybe that someone is you.
Mickey Silver, MD
President
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