Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine
by Ron Sterling, M.D. -- May 2005
Discrimination in health care insurance is manifested primarily by larger co-payments and more limitations on mental illness care compared to other health care services. Even though 34 states have passed some form of mental health insurance parity law, there is no federal parity law, and no Medicare parity law that requires equal coverage for mental illness care.
Unfortunately, the two major older American advocacy organization Web sites -- AARP and the Alliance for Retired Americans (ARA) -- devote very little space to Medicare's discriminatory mental health care coverage. Neither organization even mentions Older Americans Mental Health Week. Instead, a much smaller, but clearly more concerned organization -- Older Women's League -- carries the torch for older adult mental health care.
What can you do about the second-class status of mental illness treatment for older Americans? Here are a few of my recommendations.
I encourage you to e-mail Washington State AARP (firstname.lastname@example.org), national AARP (email@example.com), and call the Washington State ARA affiliate (425-488-7726). Ask them to take a stronger and more public stand to eliminate mental illness treatment discrimination. Ask them to recruit members of Congress to reintroduce the Geriatricians Loan Forgiveness Act (S. 2075) which died in the last legislative session. We already have a severe shortage of physicians who specialize in treating older adults and the shortage will get much worse. The Loan Forgiveness Act will encourage more physicians to become geriatric specialists. Ask AARP and ARA to work for passage of Medicare Mental Health Copayment Equity Act of 2005 (H.R. 1125), and the Positive Aging Act of 2004 (S. 2572/H.R. 4694). Visit www.MentalHealthParity.com to get more information about these bills.
Join one of the national organizations which specifically advocate for better mental health care: (1) Older Women's League; (2) Older Americans Consumer Mental Health Alliance); (3) National Mental Health Association; (4) National Alliance for the Mentally Ill; and, (5) National Council on Aging.
The Medicare Mental Health Copayment Equity Act of 2005 (H.R. 1125) will amend the Social Security Act to eliminate discriminatory copayment rates for outpatient psychiatric services under the Medicare Program. It is sponsored by Rep. Ted Strickland of Ohio. Only one Washington State U.S. Representative has signed on to co-sponsor the bill -- Rep. Jim McDermott. Write to the other Washington State U.S. House Representatives and ask them to co-sponsor H.R. 1125.
The Positive Aging Act of 2004 S. 2572, sponsored by Senator Hillary Clinton, amends the Older Americans Act of 1965 to establish an Office of Older Adult Mental Health Services. Only two U.S. Senators are co-sponsoring the bill -- Sen. John Breaux (Louisiana) and Sen. Susan Collins (Maine). Neither Senators Cantwell nor Murray have signed on to this bill. Please write to them. Ask them to co-sponsor the bill.
The best way to reduce stigma about mental illness treatment is to make sure that people don't have to pay more for their mental health care than for other health care. If the message being sent is "brain care is less valuable than heart care," how can we expect people to believe that brain health matters?
It would be nice if we could trust our leaders to have the right priorities, but we can't. Since we are the government, it is up to us to make things happen. May is a great month to start working for better mental health care for older Americans. -- Best wishes, Dr. Ron.
Ron Sterling, M.D. is a 64 year-old General and Geriatric Psychiatrist with a private practice in Seattle. He invites you to e-mail him at with any questions about mental wellness or emotional, relationship, or aging concerns. He is the only person who reads e-mail sent to Dr. Ron. Please be assured that your questions and identities are completely confidential and protected. For more information about Dr. Ron and for resources related to senior mental health, please go to SeniorMentalHealth.org. The content offered through Mind Matters is for information only and is not intended for medical, psychiatric, or psychological diagnosis or treatment. Never disregard professional advice or delay seeking it because of something you have read in this column. Read our Disclaimer. If you wish to understand more about Dr. Sterling's potential biases in health care advocacy, please check his Conflicts of Interest Disclosure Statement
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RON STERLING, M.D.
General Psychiatry with Specialization in Adult Attention Deficit Disorder
Updated October 7, 2007
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