Dear Readers:

Four months ago, the House of Representatives passed a bill that would mandate that insurers cover addiction and mental illness on par with other illnesses.

In New Jersey, similar "parity" bills, which had been approved by the Health Committees of both the Senate and Assembly (S-907 and A-2077), have been passed on their respective appropriations committees.

Both now dead in the water!  The powerful health insurance industry wins again!

Why am I disgusted?

Consider a new report on a recent study by HHS’s Agency for Healthcare Research and Quality (AHRQ): Almost one-fourth of all stays in U.S. community hospitals for patients age 18 and older, e.g., 7.6 million of nearly 32 million, involved depressive, bipolar, schizophrenia and other mental health disorders or substance use disorders in 2004.

This study presents the first documentation of the full impact of mental health and substance abuse disorders on U.S. community hospitals.

According to the report, about 1.9 million of the 7.6 million stays were for patients who were hospitalized primarily because of a mental health or substance abuse problem.

In the other 5.7 million, patients were admitted for another condition, but they also were diagnosed as having a mental health or substance abuse disorder.

Nearly two-thirds of costs were billed to the government: Medicare covered nearly half of the stays, and 18 percent were billed to Medicaid. Roughly 8 percent of the patients were uninsured. Private insurers were billed for the balance.

The study also found that one of every three stays of uninsured patients was related to a mental health or substance abuse disorder.

"Community hospitals play an important role in the treatment of people with mental health and substance abuse disorders," said Dr. Carolyn M. Clancy, AHRQ director. "This report gives health care policymakers an in-depth look at the impact of mental health and substance abuse care on the health care system."

"It signals the need for an increased national effort to identify and intervene early before the conditions require a hospital stay," she said. "Too often, because of social stigma or lack of understanding, individuals and health care providers don’t recognize the signs or treat these disorders with the same urgency as other medical conditions."

AHRQ found that most patients with mental health and substance abuse disorders were older.

For example, although people age 80 and older comprised only 5 percent of the U.S. population in 2004, they accounted for nearly 21 percent of all hospital stays for these conditions — principally for dementia.

There were also gender differences. The most frequent admitting diagnosis for women was mood disorders, while that for men was substance abuse.

AHRQ also found that patients who have these "dual diagnoses" accounted for one million of the nearly eight million stays. Nearly half of these cases with dual diagnoses involved drug abuse, a third involved alcohol abuse, and one in five involved both drug and alcohol abuse.

Also, 240,000 women hospitalized for childbirth or pregnancy also had mental health or substance abuse problems. Four of every 10 of these patients were between ages 18 and 24.

Suicide attempts accounted for nearly 179,000 hospital stays. Of these, 93 percent involved a mental health condition — most commonly mood disorders — and/or substance abuse.

Nearly three-quarters of these patients were between ages 18 and 44 and more than half were women.

Poisoning, by overdosing prescription medicines or ingesting a toxic substance was the most common way patients attempted suicide.

The report is based on 2004 data — the latest currently available — from AHRQ’s Healthcare Cost and Utilization Project Nationwide Inpatient Sample.  

Will our governor or our New Jersey state Legislatures ever, ever learn?

I doubt it!