Friday, October 03, 2008

Into Their Right Mind - Updated

Updated 10-6-08

There’s been an awful lot of attention and debate today about the passage of the mental health parity bill. It requires that if a company with more than 50 employees offers mental health coverage as part of its overall health coverage, it has to offer it at the same level as coverage for physical health. (Sadly, it doesn’t require that the coverage be offered; only that if offered it be equal.)

Oh, you didn’t know that a mental health parity bill was passed today? You thought it was all about the economic bailout?

Well, you’re right, sort of; and most news reports have said the mental health bill was tacked onto the bailout bill. However, in fact it was the other way around. Section 7 of the Constitution of the United States says, “All bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.” So. while the bailout bill was the point, it couldn’t originate per se in the Senate. Senators needed a bill that they could originate and that they could attach the bailout to.

Enter the mental health parity bill. In fact it had already been passed in both the House and Senate, but hadn’t gotten to the President’s desk. In addition, it was a matter of interest to some members of the House who had voted against the bailout plan the first time around. So, being generally acceptable and especially acceptable to some additional Representatives, it made a great vehicle for the purpose.

Parity for mental illness and addictions has been an issue for a long time. Parity had long suffered from the lingering stigma associated with mental illnesses themselves. Insurers resisted it, noting that mental illnesses were often difficult to diagnose, and were chronic, requiring years of treatment. On the other hand, with medical progress many with mental illnesses could be economically and socially functional with appropriate treatment. The same could be said for other chronic, complex diseases, such as diabetes or autoimmune disorders, which were covered. The logic for offering unequal coverage for mental illnesses could not be sustained.

So, today the House passed and the President signed a mental health parity bill, that happened to have an economic bailout bill attached (okay, so it’s not a coincidence). Of course, we’ll be living with the consequences of that economic rider for some time to come. On the other hand, for some the benefits of the mental health parity bill will make a difference for a lifetime.

Update: Yesterday on All Things Considered, NPR had coverage of the history and the importance of passage of the mental health parity legislation. It's an interesting and useful summary. You can read or listen here.


Kneelingwoman said...

Social Justice tucked into the oddest places eh? Whatever it takes! I've been reading your blog for some time but this is my first comment. I actually tried to use your email but it wouldn't "send" for some reason so, I'll ask my question here and hope that you will respond. I'm an Episcopalian in Michigan, currently doing degree work in Religious Studies plus an internship in Spiritual Direction. I am considering pursuing an M.A. in Pastoral Ministry/Theology with the idea of perhaps becoming a Chaplain. My particular interest and felt calling has to do with NICU or Perinatal Hospice as I have given birth to two sons' who both died in infancy of a genetic neuromuscular disorder and we also have a daughter with spina bifida ( and 3 older children who are, thankfully, in perfect health ). I have been trying to find out about the specific requirements for becoming a Chaplain and have, in fact, contacted some of the organizations listed on your blog but no one has answered. Both Priest and Deacon at my Parish seem to know little so........
Does one have to be ordained? If so, is ordination to the Diaconate accepted ( something I also feel strongly called to ) or even preferred? My sense of the needs of bereaved parents, as well as of those who are living through the NICU experience is that they need someone around who truly knows what they are going through and can offer both spiritual and practical assistance. I also think that spiritual direction/ companionship after loss is enormously helpful as so many seem to suffer from a sense of God's absence or lack of caring during such times; I went into Direction myself after the last baby loss of our son, Samuel and it was truly life changing for me; I would like to offer that same gift to others. Anything you can share with me would be so helpful. My contact information is on my blog which you will get to easily by clicking my moniker! Thank you so much for any information you can give me.

Marshall said...


Bless you! You certainly do have a wealth of experience to bring to the care of the suffering, and especially in circumstances of perinatal loss.

Let me suggest first that you review this earlier post. It's something I wrote specifically on becoming a chaplain.

As to your immediate questions: the Episcopal Church will endorse for health care ministries lay persons, as well as deacons or priests. To some extent, your own bishop will have an opinion; and since he's involved in the endorsement process, his opinion matters. If you do wish to be a chaplain, eventually you'll need an M.Div. or equivalent rather than the MAPM.

I can say more, but review the post first and then send specific questions. I'm sorry that the email from my profile page didn't work. I'll try to link from yours.