NOW with Bill Moyers

Transcript: Bill Moyers interviews Rep. Jim Ramstad

MOYERS: So, of this science is sure; drugs change the brain. But as we reported in the series it is possible to retrain the brain to cope with addiction. It's called treatment. Unfortunately most Americans who need treatment don't have access to it. And that's why a Republican Congressman from Minnesota has introduced legislation with the acronym HEART, the Help Expand Access to Recovery and Treatment Act, calling for substance abuse parity in our healthcare system. With me from Washington now is Representative Jim Ramstad now serving his seventh term in the House. Thanks for joining us.

RAMSTAD: Thank you.

MOYERS: I want to declare my bias. You know our son who is working in this field and believes in treatment because it worked for him. I'm on his side obviously as I know you are. You've had personal experience with this disease haven't you?

RAMSTAD: I sure have, Bill. I'm a grateful recovering alcoholic of 22 years, only because of the grace of God and the treatment experience that I had back in 1981. I've learned first hand that treatment works, that it's cost effective and I'm very grateful that I had access to treatment.

MOYERS: What happened to you? Then you woke up in jail if I remember correctly?

RAMSTAD: I woke up in a jail cell on July 31, 1981 in Sioux Falls, South Dakota and that was my first step when I realized and accepted my alcoholism and realized that I could, through treatment, start recovering from this disease.

MOYERS: How have you managed to stay sober?

RAMSTAD: Only because of the grace of God and the fellowship of other recovering people with whom I meet regularly have I been able to stay sober for 22 years now and two months. And for that I'm very, very grateful.

MOYERS: The legislation that you've introduced in the House has also been introduced in the Senate by Senator Norm Coleman, your colleague from Minnesota, also a Republican. Exactly what would this bill do?

RAMSTAD: This legislation, the Chemical Dependency Treatment Parity Bill simply requires that insurance companies not discriminate against people with addiction. Which is to say that they cannot attach limitations, conditions that they don't attach to the treatment of physical diseases. So we're trying to knock down the barriers to the treatment for people like Rush Limbaugh, like myself who are addicted to chemicals.

We're just staying to the insurance companies, "You cannot attach artificially high co-payments or deductibles that you don't attach to the treatment of other diseases." You can't limit treatment status to five to seven days which they're now doing because you don't do that for other diseases. We're just trying to eliminate the discrimination against people with addiction in terms of their treatment.

If you believe that addiction is a disease, which the American Medical Association has shown and your documentaries have shown, then you can't justify the current discrimination against alcoholics and addicts in their treatment. And that's why we need parity or equality in treatment.

We're not mandating that the insurance companies do anything. That they cover people who weren't presently covered. We're just trying to address the problem of discrimination by the insurance companies against people in health plans.

MOYERS: Wouldn't the bill add to the cost of the premiums that people pay?

RAMSTAD: At most, according to all the empirical data, we'd only experience one half of one percent increase in premiums. In fact, if the premiums were to increase more than one percent then the parity requirement is off right in the legislation. So for the price of a cup of coffee for people with health insurance we can treat 16 million Americans through this legislation.

MOYERS: Sixteen million Americans who are addicted or alcoholic?

RAMSTAD: Who are addicted and/or alcoholic and who are currently covered by health plans.

We also need to provide more Medicaid funding for the ten million Americans who are indigent and who are not covered by health insurance, I might add. This bill doesn't reach that or doesn't address that problem. But we need to do that down the road as well.

MOYERS: How do you explain the discrimination against addicts and alcoholics?

RAMSTAD: I think there's a certain stigma against this disease that doesn't exist for cancer or migraine headaches or ingrown toenails or heart disease, whatever the other physical malady might be.

MOYERS: Wait a minute.

RAMSTAD: There's a…

MOYERS: You're putting… you mentioned cancer and addiction in the same breath?

RAMSTAD: Well, because they're both diseases and we don't discriminate against people with cancer, that physical disease, and we shouldn't discriminate against people of such as Rush Limbaugh with addiction.

MOYERS: One of your staff told us that this could pass in the Senate but that it's not likely to pass in the House. Why is that?

RAMSTAD: Well, I think more House members need to be educated as well as to the nature of addiction, as to the cost efficacy of treatment. I mean, for every dollar we spend in treatment we save $7 in healthcare costs, criminal justice costs and so forth.

RAMSTAD: People like me… yeah, and business costs. People like me who have been treated who are treated alcoholics, our healthcare costs are 100 percent lower than people still suffering the ravages of this disease suffering from alcoholism and addiction or out drinking and using. So it is cost effective. We just need to do a better job of educating people.

MOYERS: On your web site I read that you've offered five strong anti-crime bills. I know that the law enforcement associations have consistently named you their favorite, if not their favorite, one of their favorite members of the House. And that you are a former prosecutor. What kind of impact does a bill like this have on crime? Are we being soft of crime where we're treating addiction equally?

RAMSTAD: Not at all. We're being smart on crime by treating addiction as a disease. By dealing with the underlying problem of criminal activity in America. Eighty-two percent of people in prisons or jails in America are there directly or indirectly because of alcohol and/or drugs.

And we need to deal with the underlying problem of chemical dependency on the part of people who commit crimes. And so this is a smart approach to dealing with crime. We need a balanced approach that includes not only tough penalties but also treatment and education as well.

MOYERS: I want to put on screen a story just this week in the Orlando Sentinel in Florida where Rush Limbaugh lives. The headline says, quote, "Help for drug addicts just got a lot less likely." And the story goes on to say that more people are sent to prison for drug offenses in Florida than on any other charge. But at the same time, the state is slashing the treatment they can get both in prison and when they are released. What does that say to you?

RAMSTAD: Well, I understand in these difficult fiscal times for not only the federal government but state governments as well that there are certain cuts that are being made across the country. And it's unfortunate that usually chemical dependency treatment for prisoners, chemical dependency treatment for people on Medicaid, that's the first area that many politicians look to for cuts which is really short-sighted and very unfortunate.

I mean, 82 percent of the people in jails and prisons today are there because of their addiction, their alcoholism. And if we don't treat the disease of addiction among those people they're gonna commit more crimes because 99 percent of them are gonna get out of prison or jail some time. And they're just gonna continue their life of crime.

MOYERS: One of the knocks on treatment is that there's a high casualty rate.

There is a story out just today that says Limbaugh apparently detoxed twice. That is he relapsed as we say in the field, and had to go to detox twice. That's not uncommon is it?

RAMSTAD: Not at all. And anyone who's been through the experience, anyone who's chemically dependent knows that it's very, very difficult to recover. The recidivism rate for most physical diseases is higher than the recidivism rate for addiction. Treatment is a viable means to recovery. Treatment doesn't work for everyone. But the statistics vis-à-vis those for physical diseases compare quite favorably as far as recovery is concerned.

MOYERS: Well, Congressman, some of us think Rush Limbaugh is wrong and misinformed and wildly biased on just about every issue he addresses. That he sees the world only as a right-wing partisan who never shows compassion to anyone who disagrees with him. But we nonetheless wish him a successful experience in treatment. What would you like to see Limbaugh do in this hour of his trial?

RAMSTAD: Well, because Rush Limbaugh is such a public person he has anywhere from 20 million to 30 million loyal listeners each week. Rush puts a very public face on addiction and hopefully through Rush's experience just hoping and praying that his treatment experience will be as valuable and helpful in beginning his recovery as mine was.

Through his experience, I'm hopeful that many, many Americans will be educated about chemical dependency and about chemical addiction. I'm hoping that the American people will finally learn what the American Medical Association declared in 1956; that chemical addiction is a disease and it's a fatal disease if not treated.

MOYERS: What's the most important thing from your own experience that you would like Limbaugh to learn?

RAMSTAD: That treatment works. And that recovery is a blessing and very, very possible. And that treatment provides the tools for recovery.

MOYERS: Someone cares about this issue, what can they do?

RAMSTAD: They can write to their Congressman or woman, write to their United States senator and urge them to co-sponsor the Chemical Dependency Treatment Parity Bill.

MOYERS: Congressman Jim Ramstad, Republican from Minnesota, thank you for joining us on NOW.

RAMSTAD: Thank you, Bill.