Readers Write: Mental health parity, college admissions, U.S. House Democrats

Thank you for the March 17 editorial urging passage of the mental health parity bill in the Minnesota Legislature. The first letter I ever wrote to a legislator was in 1994; I was 23, had my first "real" job, my first adult health insurance plan, and my first need for care for my mental health. I learned the inadequacy of having to rely upon my health insurance to cover my care, and an advocate was born. My letter was to Sen. Paul Wellstone, in gratitude for his legislative efforts and a wish for his persistence to bring equity to mental health care; and in 2008, the Mental Health Parity and Addiction Equity Act became federal law. Yet over a decade later, this law is still not enforced in Minnesota. As a social worker and citizen, I urge members of the Minnesota Legislature to support HF 1340 and SF 1229 to enforce mental health service coverage by insurance plans the same way as medical health services. It was a good idea in 1994, became a hard-won law in 2008, and now we in Minnesota can take this step forward toward ending care discrimination for those experiencing mental health and substance use disorders.

For more than 10 years, we have had laws at both the federal and state levels that require health plans to provide equal coverage for mental and physical health conditions. Most citizens take for granted that this is a reality — until, and unless, they or their families encounter a need for mental health services. Then, all too often, the lack of parity becomes glaringly clear. Minnesotans may face stigma in seeking care. Our options for help may be limited — due to a shortage of providers or the lack of accessible facilities. Ultimately, there are gaps in care, and, too often, "the system" fails patients.

The Minnesota Health Action Group is a long-standing nonprofit coalition of "purchasers" that write the checks for health care. These purchasers are employers, individuals and governments that pay for health care (not insurers that administer the coverage). For the past two years, employers have been working together to improve access to and the affordability of mental health care for their employees and families. Employers are taking actions on their own — to reduce the stigma and encourage employees to seek care, to train managers on mental health first aid and to introduce new tools to improve resilience. The Action Group also has convened a Minnesota Mental Health Guiding Coalition, creating a "common table" for employers and community stakeholders to identify and advance creative private-sector solutions.

This is a high-priority community health issue. However, it is a multifaceted challenge, and stakeholders need to advance solutions together. Legislative action now will help ensure what the law already requires — equal coverage for mental and physical health conditions. A bill before the Legislature would require proactive reporting by health plans to demonstrate that equal coverage is provided.

Some may complain that the reporting would be onerous, and others may note that it wouldn't solve all the issues. However, we agree with the Star Tribune Editorial Board. Measurement and reporting will provide transparency and promote accountability. Let's set aside politics, focus on good policy, and take an important step forward for all Minnesotans by passing this bill.

The writer is vice president of the Minnesota Health Action Group.

Suicide and opioid deaths are on the rise. Prevalence rates in young people are increasing. Now, more than ever, we need increased access to our mental health system. The mental health parity bills before the Legislature don't have new mandates or require new coverage. It's about having the data to enforce current laws. Common parity violations include arbitrary treatment limits, more limited in-network providers, more limited drug formularies, denying residential treatment, requiring prior authorizations more frequently, and requiring people to fail in treatment before accessing the right level of care. It's been 10 years — we've waited long enough. Parity is about fairness to the 1 in 5 people who will develop a mental illness in their lifetime. Let's pass the bill this session.

The Star Tribune used valuable Sunday front-page real estate on March 17 discussing the least interesting and most obvious fact about the college entrance-fraud — that it's not fair ("College scam part of 'stacked' system").

I would like to see some discussion about genuinely interesting aspects of this. For example: Why is a college degree considered so important that it is valuable even if you didn't earn it? Are elite colleges worth the money? Is college necessary for everybody? Are there less-expensive alternatives to college that would be a better use of high school graduates' time and money? As more and more people get college degrees, has their value paradoxically increased?

Clearly, people feel enormous pressure to get their kids into colleges, particularly prestige colleges. That some break the law in their eagerness is regrettable but unsurprising. That it's not fair is uninformative.

An assessment of how a college degree has gotten to be so highly valued that people go to great extremes — legal and otherwise — to acquire them, and whether or not they are worth the costs, would be a much better use of newspaper space.

Opinion editor's note: While it may not be the precise coverage the reader had in mind, an Opinion Exchange article published March 6 posed the question "What is college worth, and to whom?" Read it at tinyurl.com/opex-college.

A "Democratic circus"? These words are in the headline for D.J. Tice's March 17 column regarding his take on the Democrats in the U.S. House. The article flails from one elected official to another, using hysterical phrases such as "fellow agitators," "all but paralyzed the New Democratic majority," and "metastasizing investigations of the Trump administration" to demonize the legislators now in charge.

This is a different picture from what I see. For two years the House Republicans totally ignored White House corruption. Their only achievements were a failed attempt to make health care coverage even worse and giving a massive tax cut to corporations, worsening our already historic national debt.

The Democrats are actually doing what they are supposed to do according to the Constitution. They are acting as a check to the executive branch and writing bills to effect policies their constituents voted them in to write. The Trump mist has utterly clouded the brains of Republicans in the House and Senate, who have forgotten that they are here to work for and protect the citizens of America. I suspect the real reason Mr. Tice is so worked up is that the Democrats are actually organized, energized and extremely productive. It doesn't look like a circus to me. It looks like representative governing, and an attempt to get back to responsible leadership.