Getting to Truly Comprehensive Health Care Reform

President Obama declared the other week that there is a “clear consensus that the need for health care reform is here and now.” Ensuring that his call for comprehensive reform hears “every voice” goes beyond applause-worthy sound bites, and translates into action, is vital to fixing what ails our current system.

To date, our current health care system has been deaf to some of those voices. Among those whose important concerns are often drowned out by the chorus that surrounds health care reform, are those representing the mental health and addiction treatment communities.

Many people don’t naturally think that the mental health and addiction fields have something to contribute to the health care reform debate. But experts in these fields must be heard because addressing the causes, consequences, and treatment of these diseases is vital to constructing a meaningful and cost-effective national health care strategy. Including mental health and addiction squarely in the scope of health reform—where they belong—will contribute to the improvements we all seek in health status and controlled costs.

Today, our medical knowledge has advanced considerably since the foundations of our health care system were put in place. We know that mental health and addiction disorders are treatable and, when they are treated, significant cost savings are achieved. And yet we are wasting scarce dollars using hospitals and emergency departments as “holding tanks” for the untreated and getting poor outcomes in general medical care as a result.

Mental health and addiction disorders combined account for roughly one-fourth of total resource use in community hospitals. These disorders are involved in about 24 percent of all adult hospital stays, and 22 percent of total hospital costs. For the uninsured, they account for 33 percent of all admissions.

The numbers of people affected by addiction alone is startling. More than 23 million Americans suffer from addiction, but only one in 10 gets the treatment they need. University of Pennsylvania researchers studied the effects of alcohol or drug use, or both, on diabetes, sleep disorders, depression, and hypertension. They found that success in managing these four chronic conditions depends on concurrent management of addiction.

Congress acknowledged last year that we can not heal the system as a whole without considering all of its parts when it passed parity legislation. This new law bars insurers from imposing limits on addiction and mental health care treatment that are not applied to other health conditions. But it is not enough to ensure that these treatments won’t be discriminated against by insurers; we must make these treatments are covered.

In health care, we already know that more expensive does not necessarily mean more effective. While America spends the most per capita on health care, those expenditures have produced a health care system that the Commonwealth Fund ranked as last in quality when compared with 19 other countries.

As we examine what’s broken in today’s system, the missteps of past plans, and the elements of a successful future system, we must remember that America cannot take a piecemeal approach to what ails us today. Addiction and mental health treatment must be a part of a comprehensive overhaul of our nation’s health care system.