To the editor,

The article about the novel based on Stanley McCormick (April 3) states that he was cared for by medical professionals on the family estate. The wealthy McCormick family could afford home care. Most families must rely on some form of public aid to obtain treatment for a member who develops a serious brain disorder. Many families do not have insurance, and those who do are shocked to find that their plan has little or no coverage for brain disorders.

The number of plans that cover brain disorders has been falling for some years. The few plans that offer any coverage discriminate against people with brain disorders by requiring much higher copayments for office visits and covering fewer days of hospitalization per year. One plan, for example, requires a $5 copayment for an office visit but requires $20 if the visit is for a brain disorder; days of hospitalization are unlimited except that only 30 days per calendar year are covered for illnesses of the brain.

Inequality in insurance coverage persists because of ignorance about brain disorders and prejudice against people who suffer from them. What were formerly called mental illnesses are now known to be disorders of the brain. In some disorders, the biochemical pathways are defective. In others, structural or developmental flaws are found. Like other illnesses, brain illnesses are treated with medication, hospitalization, support services, and patient education. It would be ridiculous for an insurance company to write a health insurance policy that does not cover, say, disease or disorder of the liver. But companies throughout the industry discriminate against people whose medical disorders happen to be in their brains.

Largely because of efforts by the National Alliance for the Mentally Ill, Congress passed the Mental Health Parity Act of 1996, and about a dozen states have passed legislation to make health insurance policies less unfair. States that have the longest experience with parity in insurance have found that costs either remained the same or decreased significantly. In a study released in November, the Rand Institute analyzed data from 24 health plans and concluded that the federal parity act would cost employers about one dollar per employee annually. (A casebook detailing the successful experience of three employers with parity is available from NAMI.) However, business lobbyists continue to oppose the implementation of parity, claiming it is not affordable.

For more information on equitable insurance coverage for all parts of the body, contact NAMI at 703-524-7600 or the Chicago office at 312-642-3338.

Ellen Credille

W. North Shore