slation ildren 5-10% rgeon 0% of ed to sui Sui more ncer, lung 49% hese ugh e at end hil ess It CO mer ps. ni on of of to n n e ( STATEMENTS OF PETE V. DOMENICI, A U.S. SENATOR FROM Senator DOMENICI. Thank you. Well, I regret what happened this morning because this bill, Mr. Chairman and fellow Senators, is truly a bipartisan bill, not only in that it is called DomeniciWellstone, but we have 10 Republican Senators on this, and I believe in due course we will have more. As of today, we have 41 Senators cosponsoring this, and I believe its time has come. If we have to wait for a week or 2 weeks for something procedural, and if you need me to come back, Mr. Chairman, don't worry about that. I have been waiting a long time to have a hearing on this kind of legislation. In 29 years in politics, while I have done a lot of things, if we pass parity of insurance treatment for those American with mental illness and it gets by the House and gets signed into law, I think I can say I have been part of one of the most serious and significant activities in terms of wellness for the mentally ill people of this country. You have many witnesses, so I won't go through how many people are involved. That is all available to you, excepting you should know a couple of things. The efficacy of treatment is higher in trying to cure and stabilize some of the serious mental illnesses; efficacy is higher than for heart operations and heart treatment. What actually happened is sometime in history when the insurance plans and insurance coverages were evolving in America from sporadic to large numbers, and then to employers buying insurance for literally millions and millions of Americans, insurance has provided resources to the professionals and the private sector people who want to be involved in making people well. What happened at that time when these policies started to get developed is they left out mental illness, just because it was not like all the other illnesses; it had some vagaries to it. Essentially, I asked the question-I have asked it across this land-what if we had excluded from health care the human heart? That is rather arbitrary, but they have been rather arbitrary about mental illness. So let's assume the heart is not covered, Senators. Where do you think the wellness of heart patients would have been? Would we have all of the technological breakthroughs for heart treatment that we have? My answer is no, because success requires resources. Helping people who are sick requires that they have some re sources. Now, I have been active for more years than I can remember with the National Alliance for the Mentally Ill. I know something about mental illness, but I also know that there are thousands and thousands of American families who have gone literally bankrupt in trying to care for their schizophrenic daughter or seriously depressed young son, or even beyond that a serious mental illness at another age. What happens is they run out of money. They come and tell me at meetings, we have nothing left and our son is a schizophrenic and we have no coverage; nobody will help him, he is probably walking the streets of San Francisco at this point, but we don't have anything left because we gave him the best care possible. 8 Now, think with me for a minute. If, in fact, we ha mental illness just as we did the heart-you know, the some spirituality to it, if you are talking about mental being something that you can't quite touch and it is in The truth of the matter is, had this been covered, we w community health centers taking care of the mentally ill a land, Senator. When your brother decided let's move ahead and get the out of the insane asylums and out of the prison cells, the to develop some local community mental health centers. B always dependent in the first years on the Federal Go paying for it and we didn't, did not. Now, what is going to happen is, if you pass this, every ill American that has insurance either directly or throu family progeny, children, insurance will have to cover mental illness, if they cover mental illness at all, to the ex level that they cover cancer illness, diabetes disease, all Let's just pick a group. Every schizophrenic family wh child or two is carrying on their back like a backpack r Resources for what? Resources to take care of their illness care of them if they have to go to a center, to take care if they have to be hospitalized. And, you see, what will happen in a decade or two is t be facilities because people will charge to treat, we expec there is money to pay it, facilities are going to get built that is what is happening elsewhere. Have you ever seen hospital? I have, because the heart has become such a re part of our body that now you need to take care of them i cial facility. Who pays for that beautiful hospital? Are onl millionaires in the hospital? Of course not. Însurance pay Now, here we are with millions of Americans; generally phrenics are between 18 and 27 years of age when it co Manic depressives, with all the suicides that are growingalso a youthful one, but it also affects seniors. Bipolar is a disease. It is now defined with sufficiency, and there is treatment and there are drugs that take care of it. But v have the resources because the resources do not follow; in does not follow as a resource to the sick individual. In the process of getting here this day, I remember one that I received. It is in my office. It is not very big, but it i like a victory bell with a crack in it, like our victory bell. given to me at a Mental Health Association meeting and it metal in the bell all came from the prisons that housed th tally ill. So they proceeded to buy up some of the wrought i others as sick people got of these hospitals and they made of freedom for those whom they think deserve it. Now, if there are some who believe that we should not because it is too expensive, I don't have the time, nor do yo me to speak as long as it would take me. But I believe it i to be obvious to this committee, just absolutely obvious, th matter of fact there are huge numbers of the seriously ment We are not talking about a little bit; we are talking about Second, the business people are paying a lot of money ou now for not having coverage because there is a huge loss of tivity and there is a huge loss of time. Anybody who works the seriously mentally ill knows that even when they are on healthy, very widely prescribed drug, they do have trouble. times they quit the medication, so they don't go to work. So think the business community would back this. We will put in the record now, with your permission, an letter from the Congressional Budget Office. They have a this and they say American people who are mentally ill treated just like the Federal employee health plan. That is sence of this bill. [The letter referred to was not received at press time.] Senator DOMENICI. Now, without any question, it mig some cost, but the Congressional Budget Office says it mig 1 percent. We had much bigger readings before when we fi the bill, which you alluded to. But, essentially, I believe wh happened is because of medication, because of treatment, b some people have now tried it-and you don't have to do model; you can go ask a company that insures 50,000 peo has become less expensive rather than more expensive. I wouldn't think before we are finished this episode in An history of arbitrary denial or accidental denial-nonethel should not go on forever. I mean, we said it isn't covered b it is the brain. OK, but how many more years do we have t saying that when we know now where the diseases are brain? Because of the magnificent type of research going will know precisely what part of the brain is affected when y bipolar. We know the effect of medicine right on the living because we will be able to take pictures of it as it assimila drugs that would be given for a cure. These are exciting things, and right square in the middl Mr. Chairman, is are there going to be any resources to s this exciting research continues and that people are cov would think when you report this bill out will be a day when this land millions of parents who have gone through suicida agers because of depression, who have gone bankrupt try take care of their 19-year-old son with treatment and hospita the like I would think that they would have the opportu take a real, real breath of hope. Now, for those who continue to say we shouldn't do th should leave it up to someone else, let me say I have come conclusion, not consistent with everyone on this committee, think the Government in some areas can't do very well. Bu firmly convinced if you leave the mentally ill and the ins issue to evolve without us stepping in, it will never evolve There will be less resources and we will never make the cur do treatment that, in fact, we absolutely know must occur. We are all talking to the Leader about having hearing Chairman, but I think the sooner you can work out somethin your ranking member, the sooner we can proceed. Now, I want to thank my cosponsor. This bill is known Domenici-Wellstone bill. The first was that and this one is appreciate his tremendous efforts in working to get people port. Over 141 organizations back this bill as of your hearing and my friend has a lot to do that. 10 Thank you very much. The CHAIRMAN. Well, thank you, Senator Domenici. I d what your time frame is. Are you going to be able to rer us through Senator Wellstone? Senator DOMENICI. Yes, I will. The CHAIRMAN. Good, because I have some questions. [The prepared statement of Senator Domenici may be additional material.] The CHAIRMAN. We will hear from Senator Wellstone. Paul, we welcome you here, a member of our comm know how strongly you feel about this issue and the stron ship you have provided, along with Pete Domenici. So w lighted to hear from you on this, as we always are. Senator WELLSTONE. Well, thank you, Mr. Chairman. I to try to be very brief so we can go to some of your que want to say a couple of things at the beginning. First of all, I want to thank each and every one of you here. It means a great deal to us, and I think more impor means a great deal to the other people who are here repr a lot of groups and organizations, and it means a lot t throughout the country. Second of all, I want to say I could acknowledge the worl and every one of you because all of you have worked in t I did want to say to Senator Kennedy that I remember wh a college teacher following his work in the mental health a I very much appreciate his leadership as Chair of the co But then I could start talking about each and every one Thank you. It has been an important effort working with Senator D I think he deserves a tremendous amount of credit for his ship. Senator Domenici, I think today the announcement that t has done the scoring on this and we are talking about 1 by way of premium increase is extremely important news. We have 41, Mr. Chairman, cosponsors right now; Senat erts, I think, and I think Senator Collins is a cosponsor. know if I am right or wrong. If I am wrong, I apologize. Senator ROBERTS. Soon to be. Senator WELLSTONE. Soon to be. Maybe soon to be; I hope We have 41; we have 10 Republicans. I really believe thi tremely good news. But I believe that Senator Domenici d a tremendous amount of credit, as does his wife, Nancy Do She is in the back of the room. I wonder if Nancy would ing to stand up because she has done just fabulous work. The CHAIRMAN. Nancy, we want to recognize you. [App Thank you very much. Senator WELLSTONE. At least I can find one or two other I agree with Nancy on. With him, it is almost impossible. [ ter.] Senator DOMENICI. This is a pretty good one. Senator WELLSTONE. This is a pretty good one. Some years have gone by since we passed the partial par in 1996, and it is a changing health care picture. We kno there are increasing numbers of people who are denied ad mental health treatment. There has been a lot of very good j ism on this and you just see the courage of people who ha willing to tell their stories. We also know that medical science has advanced in the brain research and medication and psychotherapy treatme truth of the matter is that so much of this illness, Mr. Cha is diagnosable and treatable. Kay Jamison, who, as you know, does powerful writing, chiatrist herself who has struggled with this illness, once I just always remember her words "the gap between w know and what we do is lethal". So if we could really get th ment to people, what a difference it would make. We also know that employers are increasingly aware th good to provide this coverage; it is good, sound business p Their employees and their families want this coverage and be done in a cost-effective way. We also know that the Feder ernment-and indeed that is what this bill is patterned knows that this is the right direction to go. We have introduced this Mental Health Equitable Tre Act. What it does is ensure that private health insurance nies provide the same level of coverage for mental illness do for other diseases. It is that simple. It is based on the employee health benefit package which became effective J 2001, so there just shouldn't be any different with deductibles, outpatient visits, or days in hospital. This heari be, Mr. Chairman, a critical step forward to pass this piece lation. One of the things that happened post 1996, Senator Dome that we were trying to say at least with annual and lifetime plans must provide the same coverage for physical and me nesses. But we found that too many people from the beg were denied coverage, so it didn't really make much differe this bill is a necessary and huge step toward ending the di nation and getting the coverage to people, to children, to adu Now, Mr. Chairman, I want to just point out that there i to be some powerful testimony, and one statement in the was submitted by Stanford Alexander, chairman of Weingar alty Investors, which is a Texas-based company with prope 15 States and I think, Senator Domenici, over 200 employees he states is that his company fully supports Federal legisla establish parity for mental health insurance coverage, and lieves it is good business practice, and we should do it. We have 41 cosponsors, and as Senator Domenici said, a groups and organizations. There are a lot of people who c this hearing today. I really believe that part of the reason t are here today, part of the reason we will mark up the bi part of the reason we will bring it to the floor, and I believe pass and I believe it will become legislation, is because of th age of so many people who have been willing to step forwa tell their story and say we no longer can accept this stigma, no longer accept this. They say, you know, we refuse to b whether it is us or whether it is our family members, that second-class citizens because we struggle with this illness. |