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Search Terms: mental, health, parity

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October 28, 2000

SECTION: POLITICS; Pg. 3410; Vol. 32, No. 44

LENGTH: 791 words

HEADLINE: A Gore White House: Tipper: A Voice for Sanity

BYLINE: Sydney J. Freedberg Jr.

BODY:

In the third and last presidential debate, Al Gore touched on two
issues dear to his wife, Tipper. One was the crusade for which
she is best known-policing pop culture. It is the other, however,
that promises to draw more of Mrs. Gore's energy as first lady.
Although Gore did not mention Tipper's name when he brought up
the second issue, he made sure to embrace her position. Declared
Gore: "We have got to fill in the gaps in (health) coverage by
finally bringing parity for the treatment of mental illness." Indeed, Tipper Gore's quiet influence on how mental
illness is regarded, and paid for, in this country has been
notable in recent years. Robert O. Boorstin, a former White House
aide who has struggled all his career with manic depression,
said: "(Mrs. Gore) has been the champion, of legislation, of
standards, of executive orders, of any kind of executive-branch
activity that relates to mental illness.... If she were to become
first lady-knock on wood ... she would bring that commitment with
her to the East Wing."

As with her war on explicit rock-music lyrics, which
began when her daughter brought home a Prince album, Mrs. Gore's
commitment to mental health combines the political and the
personal. "This lady goes into Lafayette Park and fishes homeless
people off the street to take them into treatment," said Al
Guida, the executive director of a Tipper-inspired public service
ad campaign aimed at mentally ill youth. "You just don't find
that kind of hands-on activism among high government officials."
Tipper's mother had recurring, disabling bouts with depression,
and the Vice President's wife herself received not only therapy
but medication after her son Albert III's near-fatal accident.

But Mrs. Gore has gone beyond the "celebrity spokeswoman"
model often associated with crusading first ladies and has
lobbied aggressively for policy reform. Before the Clinton-Gore
Administration, applicants for sensitive federal positions faced
open-ended questions about "problems on or off the job because of
any emotional or mental condition." Background checks could
involve free-ranging interrogations of the applicant's therapist
on any subject, job-related or not. Today's government inquiries
are limited to questions about serious mental illness only in the
past seven years, and interrogations of therapists are
restricted. All sources agreed that Mrs. Gore's quiet campaign
helped drive the change.

Mrs. Gore has also lobbied successfully on mental health
insurance. Starting next year, the Federal Employee Health
Benefits Program will guarantee coverage on the same terms-same
deductibles, same co-payments-for mental and physical illnesses
alike, a reform activists call "parity."

Bringing parity to private health insurance was also part
of Tipper's efforts. The key legislation was introduced by Sens.
Pete V. Domenici, R-N.M., and Paul Wellstone, D-Minn., in 1996.
Initially stymied, the Domenici-Wellstone language ended up as an
amendment to an appropriations bill-where Mrs. Gore made sure it
survived the madhouse of White House-Congress year-end
negotiations. Said Andrew Sperling of the National Alliance for
the Mentally Ill: "I know for a fact that she directly contacted
the (Office of Management and Budget) director at that time and
did quite a bit of table-banging, and said, 'You are going to
fight for this amendment.' "

The Domenici-Wellstone law passed, but is set to expire
in 2001. Wellstone, Domenici, and such activists as Sperling want
it not only renewed but also expanded to eliminate what they see
as loopholes left by the 1996 act. But the Health Insurance
Association of America and some business groups oppose what they
see as a massively expensive federal mandate.

"We have to realize that while mandates provide more
options to those with health insurance, they also end up with
fewer people being insured," because they drive up insurance
costs, said John Emling, legislative affairs manager of the
National Federation of Independent Business. In a laughing-but
not entirely joking-reference to Mrs. Clinton's role in the ill-
fated 1993 health care plan, Emling added: "We survived Hillary
Care. We hope there's not a Tipper Care."

It is unlikely that the soft-edged Tipper Gore could ever
be the kind of lightning rod that Hillary Clinton became after
1993. But it is equally unlikely that she would emulate the
grandmotherly Barbara Bush, with her uncontroversial crusade
against illiteracy. "This is someone who's passionately
committed," Boorstin said.

LOAD-DATE: October 31, 2000

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