Susan Froemke, the producer of HBO's Addiction, interviewed Mike Zamore, policy adviser to Congressman Patrick J. Kennedy. Susan spoke with Mike about The Paul Wellstone Mental Health and Addiction Equity Act introduced to Congress on March 7th, and how HBO is helping bring awareness to understanding to issues surrounding addiction.
Susan Froemke - Can you talk about the genesis of the bill?
Mike Zamore - It's called the Paul Wellstone mental health and addiction equity act. It's a symbol of equality, a civil rights bill. If you pay your insurance premiums, the disease you have is just as worthy of treatment, you are just as worthy of treatment, as anyone else. Addiction is a physical, biological, genetic disease, just like any other disease.
In 1996 Congress passed the first mental health parity act. It only applied to catastrophic limits, annual and lifetime. Healthcare plans responded by applying limits on access, increasing co- pays, etc. Since then we've been trying to close loopholes and bring parity to coverage for mental illness and addiction with other illnesses. It's been a long road, but we have major support from both houses and are making strides.
Now with the Democratic majority, we finally got the chance to bring the bill to Congress and introduced this past Wednesday, the 7th. Rep. Kennedy had 255 colleagues put their names on the bill as co-sponsors. That is a strong bi-partisan majority saying right out of the gate that they want this bill to become law. We also have a pledge from the Speaker of the House that this will get a vote on the floor come spring.
Additionally, there is a website, www.equitycampaign.net, where visitors can put their names on the bill to "co-sponsor" it as well. The site also has Information on field hearings that Congressmen Kennedy and Ramstad are holding throughout the country.
Froemke - We just finished a three-year effort with HBO's Addiction. I directed a segment called "Insurance Woes." As I was developing the film, I talked many families. The biggest obstacle they faced in getting access to treatments was managed care. Can this bill change that when it becomes law?
Here are families that have been paying premiums regularly, but they can't access coverage they've paid for. How will this bill stop the practice of managed care?
Zamore - We can't turn back clock on managed care entirely, but we need to ensure that there's a measure of fairness and justice on how it operates. People who are sick and need help should be able to get what they need. This bill is a start but won't solve all the problems.
We're trying to do a couple things in the bill to combat managed care. The first step is to make sure that the coverage is there on paper and that plans are being held to principles of equality - mental health and addiction on one hand, physical care on the other. We have to make sure that the promises implicit in a health insurance policy aren't broken.
Froemke - What are you hearing when you travel around listening to people with insurance issues?
Zamore - We hear amazing stories of redemption; stories from people who lost years or decades of their lives, spent years on drugs, in jail, unemployed, broken relationships, homeless. Later on, through the intervention of some angelic benefactor or an excellent community program - these people finally got the chance to get treatment, to get sober, and pull their lives together.
There's a very poignant realization when you speak with someone who's personable and a powerful advocate; someone with a family and kids. To hear them talk about all the time and dreams that were lost. If they had access to treatment 20 years earlier, the person that you're seeing now could have been there the whole time.
That's what really impressed itself among Congressmen Kennedy and Ramstad. You hear about all these terrible issues surrounding addiction - jail and emergency room visits - but once you hear first hand the toll that it takes on people's lives, you begin to see the real face of the disease and who it's affecting.
Froemke - In making Addiction, we saw that family members would get assessed by a family care doctor, but then managed care would come in and prescribe different types of treatment. Does this bill give the power back to doctors?
Zamore - The bill starts to address that issue, but that's a problem throughout healthcare and not just limited to addiction. It's certainly a larger problem with addiction. There are a couple provisions throughout the bill that at least try to level the playing field with doctors and managed care though. Patients and providers will get more transparent access to criteria from managed care providers. This makes the information more transparent and less ambiguous.
The bill also sks the Government Accountability Office (GAO) to look at the availability of uniform patient placement criteria. Are plans using those criteria to manage benefits? If there aren't such generally accepted criteria in place, the bill asks GAO to establish processes to create them. We need benchmarks to hold managed care up to. We want to make sure that the benefits are managed in ways that are responsible and appropriate.
Froemke - How do you see the bill progressing?
Zamore - Hard to predict we're hoping there will be a vote in the House come summer. The Senate already has a bill ready to go to the floor, but it's easy to block things in the Senate. Our concern is that it doesn't get hold hostage in the Senate.
Froemke - We were in Washington March 1. Congressmen Kennedy and Ramstad spoke at an event where we showed Addiction. Has there been any interaction between the Addiction project and the progression of the bill.
Zamore - hopefully there's a virtuous circle here. In order to build momentum, we need people to acknowledge the impact of these diseases and the need for treatment. Essentially we need to break down this prevalent stigma. HBO's project helps move the bill forward. The project is tremendously valuable in helping to dispel myths and make it ok for people to talk about addiction in an open and honest way. If the project helps do that, it helps our efforts.
To the extent that HBO awakens people to this issue, it can only help with the political movement we're hoping to build. Addiction and mental health, between the two of them, every single family in the US is touched. That should make for a powerful political constituency.
Froemke - the outreach we've been having for community groups, has grown like wildfire. I agree that we've got to get people to speak out, and some groups are already doing that. We need to put a face on recovery so people can see that it's a middle class issue that affects your neighbor, your parents, and your child.
These smaller groups throughout the country will become the voice of recovery. People are fed up with others looking at their children as throwaway kids. I think the mother's groups are going to become the political voice here.
Zamore - We really need people to get involved. Speak to their members of Congress, sign up to be co-sponsors on the bill, demand change. The status quo should be unacceptable. The way we treat our mothers and fathers and children and neighbors and friends is not consistent with our ideals. It's time to invite them into the American dream and the promise of reaching their potential. We know there are treatments that work. It's immoral and foolish for us to deny people this chance.