Imagine this scenario in the emergency room of a hospital near you: Two patients lie on gurneys. Each suffers from an acute illness that may be life-threatening. The patients live in the same neighborhood and even work at the same job for the same large company.

       A doctor approaches the first patient and conducts a thorough examination. The doctor writes out a long list of orders, diagnostic tests and medications for the patient. The doctor suggests that the patient be admitted to the hospital. All the forces of modern medicine swing into motion. The same doctor moves to the next gurney. The doctor examines that patient, then speaks to patient's family, informing them that the patient is indeed in crisis and needs immediate attention followed by longer-term care, but there is little the hospital can do. The doctor says the patient will be stabilized, and then must be taken elsewhere.

       A scene from a Kafka novel? Some kind of surrealistic nightmare?

       No. In reality, it's a scene that plays out regularly in many hospitals because of a loophole in the laws of many states that allows insurance companies and HMOs to provide drastically reduced benefits to sick people if they happen to have the wrong disease. Impossible you say? Not so. The first patient may have been suffering from an acute attack of diabetes, asthma, a heart attack or a stroke. The second patient was in an equally debilitating and life-threatening crisis: an acute psychotic episode or bipolar mania or depression, or perhaps schizophrenic hallucinations or delusions.

       The laws in these states allow insurance companies and HMOs to provide far less coverage for mental health care than for physical ailments. The U.S. Bureau of Labor Statistics says 96 percent of insurance plans impose limits on mental health care benefits that are not placed on physical ailments. The unfortunate irony is that we now know that most of the diseases that are known as "mental illness" are, in fact, physical ailments caused by chemical and physiological changes within the brain. No one chooses to be mentally ill any more than one chooses to be a diabetic or a cancer victim.

       President Bush has proposed federal legislation requiring health insurers and HMOs to provide the same benefits for mental health and substance abuse care as they do for other physical ailments. This concept is known as "parity."  Opponents argue that such a law would cost insurance companies more money and ultimately increase everyone's premiums, but the facts are otherwise. In North Carolina, after parity was enacted for state employees, mental health care costs dropped 32 percent. In Maryland, comprehensive parity resulted in an increase of 1 percent in total premiums, hardly the quantum leap feared by opponents.

       On Jan. 1, 2001, the federal government implemented parity for its 9 million employees.  But other states have fallen far behind the curve of enlightened and progressive health care for its mentally ill citizens. Passage of federal parity legislation would reverse that direction. There are no economic arguments to be made against them, and countless humanitarian arguments to be made for their passage.