Copyright 1999 Federal News Service, Inc.
Federal News Service
OCTOBER 21, 1999, THURSDAY
SECTION: IN THE NEWS
LENGTH:
1533 words
HEADLINE: PREPARED STATEMENT OF
SENATOR
PAUL D. WELLSTONE
BEFORE THE HOUSE GOVERNMENT REFORM
COMMITTEE
CRIMINAL JUSTICE, DRUG POLICY, AND HUMAN RESOURCES SUBCOMMITTEE
SUBJECT - SUBSTANCE ABUSE TREATMENT PARITY
BODY:
Mr. Chairman, I want to thank you for the opportunity to speak to
the subcommittee this morning on an extremely critical health
issue facing millions of Americans - parity for the treatment
of drug and alcohol addiction.
Last July, I introduced legislation (Fairness
in Treatment: The Drug and Alcohol Addiction Recovery Act of 1999, S. 1447) that
will ensure that private health insurance companies pay for
substance abuse treatment services at the same level that they pay for treatment
for other diseases. Today, you will hear powerful testimony about how badly this
treatment coverage is needed, how substance abuse has affected the lives of so
many Americans throughout our country, and how the costs for such treatment are
very low.
Drug and alcohol abuse addiction is a chronic, relapsing disease.
For too long, it has been viewed as a moral issue...or a measure of personal
weakness. We have all seen terribly negative portrayals of alcoholics and
addicts as less than human, as somehow unworthy of treatment, and these only
reinforce the biases against people who have this disease. Such portrayals would
not be tolerated if they were made of individuals suffering from cancer or heart
disease. They should not be tolerated with those who are suffering from the
disease of addiction.
Alcoholism and drug addiction are painful, private
struggles with staggering public costs. A study prepared by The Lewin Group for
the National Institute on Drug Abuse and the National Institute on Alcohol Abuse
and Alcoholism estimated the total economic cost of alcohol and drug abuse to be
$246 billion for 1992. Of this cost, $98 billion was due to drug addiction to
illicit drugs and other drugs taken for non- medical purposes. This estimate
includes addiction treatment and prevention costs, as well as costs associated
with related illnesses, reduced job productivity or lost earnings, and other
costs to society such as crime and social welfare programs. The study also
determined that these costs are borne primarily by governments (46 percent),
followed by those who abuse drugs and members of their households (44 percent).
According to this same study, private health and life insurance
companies bear only 3.2 percent of the costs of drug abuse and 10.2 percent of
the costs of alcohol abuse.Insurance companies and employers fear rising costs.
But the truth is, the costs are very low, and must be considered against the
costs of the failure to treat. We must also recognize that we as a country
already pay for the costs of this disease in so many other ways. Of all general
hospital patients, 25-50% suffer from alcoholism-related complications,
according to a 1996 commission on Model State Drug Laws. In addition, 65% of
emergency room visits are alcohol or drug related. Business pays already too,
for the failure to provide treatment. The same report said that drug and alcohol
abuse costs American businesses nearly $100 billion in increased medical claims,
medical disability, injuries, and decreased productivity. But it doesn't have to
be this way for businesses. After treatment, employee absenteeism, disability,
and disciplinary actions all decreased by more than 50%.
Today, our country
spends in excess of $17 billion on the drug war, yet more than 90% of high
school seniors still say that marijuana is 'easy' or 'fairly easy' to obtain.
Two-thirds of the drug control budget still focuses on law enforcement and
'supply reduction' and only one-third still is expected to cover public
expenditures for drug treatment, education, and prevention. Yet, we know from a
landmark study of cocaine markets by the RAND Corporation that, dollar for
dollar, providing treatment to cocaine users is 10 times more effective than
drug interdiction schemes and 23 times more cost effective than eradicating coca
at its source. Until we devote adequate resources on drug treatment,
rehabilitation and prevention, our country will continue to consume billions of
dollars worth of drugs.
Who doesn't pay - not yet - are those insurance
companies who discriminate against individuals suffering from the drug and
alcohol addiction by refusing to provide treatment, or by setting up impossible
barriers to care. As a result of these barriers, many individuals do not get
treatment, and the consequences can be very tragic. The costs that the
individual, and the individual's family, friends, coworkers, employers, and all
of us suffer are enormous.
What is the cost for parity for
drug and alcohol abuse treatment? A 1999 study by the Rand Corporation found
that the cost to managed care health plans is now only about $5
per person per year for unlimited substance abuse treatment benefits to
employees of big companies. Research on 93 health plans
indicates that drug abuse treatment accounts for less than 1% of the cost of
health insurance overall, and for only about 13% of insurance
payments for behavioral health care coverage. One study
estimated that a full and complete drug and alcohol abuse
parity provision would increase"'composite" per capita
health insurance premiums (aggregated across fee-for-serves,
PPO, and HMO plans) by only 0.5%, or less than $1 per member per month. A recent
Chevron study reported that for every $1 spent on drug and alcohol addiction
treatment, $7 is saved in related costs.
Parity for
treatment of drug and alcohol addiction and mental illness is a
growing movement. Over the past few years, the principle of
parity in insurance coverage for alcohol and drug
rehabilitation and treatment has received the strong support of the White House,
ONDCP Director General Barry McCaffrey, Former Surgeon General C. Everett Koop,
Former President and Mrs. Gerald Ford, the U.S. Conference of Mayors, Kaiser
Permanente Health Plans, andmany leading figures in medicine,
business, government, journalism, and entertainment who have successfully fought
the battle of addiction with the help of treatment. Hearings held last year by
the Senate Appropriations Committee and the Committee on
Health, Labor, Education, and Pensions highlighted the recent
major advances in scientific information about the disease; the biological
causes of addiction; the effectiveness and low cost of treatment; and many
painful, personal stories of people, including children, who have been denied
treatment. In addition to federal parity legislation, more than
half of our states have passed some form of mental health or
substance abuse treatment parity. It is time for the federal
government to enact legislation to provide for full treatment
parity for drug and alcohol addiction and
mental illness.
Dramatic advances in neuroseience and the
behavioral sciences have revolutionized our understanding of drug abuse and
addiction. New information about brain circuitry, neural receptors, and
biochemical changes have greatly increased scientific knowledge about the clear
changes in the brain caused by drug addiction. We would not discriminate against
other diseases when the brain is affected (such as Alzheimer's disease); we must
not discriminate against this disease. Social attitudes and clinical practice
have not kept up with these advances in scientific knowledge, but it's time to
change our attitudes and make sure that the treatments that we know work are
accessible to those who need them most. There are good treatments for drug and
alcohol abuse addiction, like the programs at the Hazelden Foundation in my home
state of Minnesota, at the Betty Ford Center, and at the Valley Hope
Association, and there are many community based programs that have effective
programs that combine medical treatment provided by qualified professionals,
with the social support that is needed to help those in recovery.
The 1999
Drug and Alcohol Addiction Recovery Act (S.1447) does not mandate that
health insurers offer substance addiction treatment benefits.
What it does is prohibit discrimination by health plans who
offer addiction treatment from placing unfair and life-threatening limitations
on caps, access, or financial requirements for addiction treatment that are
different from other medical and surgical services. This bill will exempt small
employers of 25 or fewer employees.
In closing, the important thing to
remember is that drug and alcohol abuse treatment is about fairness, plain and
simple. Drug and alcohol abuse is a chronic, relapsing disease, and it needs
coverage that can allow proper management of this disease. To fail to provide
treatment for those suffering from this disease is costly, and leads to broken
families, broken lives, and broken dreams. We need to do more to help. This
hearing today is an important step to making sure we change the attitudes and
practices in our society that lead to this discrimination. A critical next step
is the passage of the Federal legislation that will ensure treatment
parity for drug and alcohol addiction.
We must move forward
now to vigorously address the serious and life- threatening problem of drug and
alcohol addiction in our country. It is long past time that insurance companies
do their fair share in bearing the responsibility for treating this disease.
Thank you.
END
LOAD-DATE: October 23, 1999
