So Near, Yet So Far: Achieving Parity in Mental Health Care

Jeffrey A. Lieberman, MD


December 05, 2013

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Historic Opportunity for Patients With Mental Illness

Hello. This is Dr. Jeffrey Lieberman of Columbia University, speaking to you today for Medscape. The title of my commentary today is "So Near, Yet So Far." It specifically has to do with the process of achieving parity in healthcare for persons with mental illness.

There are 2 pieces of legislation that have given historic opportunity to people who suffer from mental illness and the healthcare providers who treat them. On November 8, the final rule for the Mental Health Parity and Addiction Equity Act that was passed in 2008 was finally issued by the Obama Administration. This has been long awaited and long anticipated by the mental health community, because even though the act was passed in 2008, it was not fully implemented until the rule describing its elements, and how it was going to be implemented, was completed and issued. That just happened. By coincidence, it occurred at the same time that the Affordable Care Act was being rolled out, which is the historic healthcare legislation to provide mandatory healthcare to people in the United States, enabling up to 40 million people who were not insured to have healthcare insurance.

These 2 things converging like this gives people with mental illness and healthcare providers who treat them a historic legislative advance because it enables people who otherwise didn't have insurance to obtain it and avail themselves of healthcare services, including mental health care, in one fell swoop. At the same time that the Affordable Care Act would be implemented, the policies would be required to be implemented by the principals established in the Parity Act, meaning that the same level and types of services for medical and surgical patients would need to be offered in insurance plans for mental illnesses. Together, they will have tremendous impact of historic significance. However, the reason I say that we are so near yet so far is because there are now questions about both.


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