Illness is illness.

Byline: The Register-Guard

There will come a time when people will shake their heads in disbelief upon hearing that mental health was once considered less important than physical health. The Oregon Senate did its part to hasten that day with a bipartisan vote Monday that requires insurers to cover mental illness and substance abuse the same way they cover physical ailments.

With five Republicans joining all 18 Democrats, the Senate voted 23-6 to send Oregonians an overdue signal that the stigmatizing disparity in insurance coverage must be eliminated. Now it's up to the Republican-dominated House to follow suit, allowing Oregon to become the 35th state that requires some form of parity between mental health and physical health coverage.

The bill faces a hard road in the House, where powerful opponents in the insurance industry and the business lobby will do their best to damn the measure with faint praise:

"Parity may be the right thing to do, but unfortunately, we can't afford it."

"It's a feel-good method for sticking the private sector with huge new health costs."

"The real result of parity will be to force insurers and employers to cut back on coverage to pay for new mental health benefits."

That strategy has worked for years to squash every previous attempt at passing a parity bill. But it's bogus. The 10 states that have adopted comprehensive mental health parity have documented premium increases of less than 1 percent. More important, not one of those states has moved to reverse its law.

The Congressional Budget Office estimates that a national parity bill sponsored by Sens. Edward Kenne- dy, D-Mass., and Pete Domenici, R-N.M., would increase premiums by only 0.9 percent. Common sense suggests that comprehensive mental health insurance stands a decent chance of reducing costs because, as with physical illnesses, people would seek care early on rather than in an emergency room. Or before it's too late.

Suicides alone account for more annual deaths worldwide than homicide or war, according to the World Health Organization. Mental illnesses such as bipolar disorder have a higher mortality rate than some forms of cancer.

It has taken far too long, but attitudes about mental illness are finally catching up with scientific understanding. The documented biological origins of mental diseases and breakthroughs in psychopharmacology have convinced state and national lawmakers of the need for parity in mental heath coverage.

Oregon law requires private health insurers to provide mental health coverage, but it allows them to set limits, such as capping the number of therapy sessions, limits that don't apply to physical ailments. Someone with chronic high blood pressure can seek treatment as needed, while someone with chronic depression may only be allowed a set number of treatment sessions a year.

Even if a parity law passes in Oregon, insurers will face complicated decisions about what constitutes equivalent treatment. But they won't be the first to confront such questions. After consultations with other states, it shouldn't take long for a sensible system to emerge.

Illness is illness, whether it's mental or physical. That's how it feels to a patient, and that's how it should be covered by insurance.