July 2, 2003
Note in Yale Law Journal Wins National Writing Prize
Sonja B. Starr '02 won this year's Ross Student Writing Contest for her student note in the Yale Law Journal (Volume 111, Number 8), "Simple Fairness: Ending Discrimination in Health Insurance Coverage of Addiction Treatment." The Ross Contest is sponsored by the ABA Journal Board of Editors and recognizes one student-written law review article from an ABA accredited school. It is also one of the most lucrative legal writing competitions, carrying a prize of $7,500.
The contest was judged by a panel of law professors and practicing lawyers, who evaluated each submission for quality of legal thought, writing style and readability, as well as usefulness to the practice of law. Each journal or law review was only able to nominate one paper published in the last year for the contest, and Starr's paper was selected out of sixty-four entries.
Starr's paper argues for parity between health insurance coverage of treatment for drug and alcohol addiction and treatment for other diseases. The paper opens with a consideration of current shortfalls in such coverage, noting that "Some estimates suggest that only 2% of substance abusers have health insurance plans that provide adequate coverage for treatment." She argues that many of the limitations and exclusions of coverage that apply only to substance abuse treatment constitute discrimination. And yet, Starr notes, there is a broad consensus in the medical profession that addiction is a disease. She also points out that treatment for addiction is both effective and cost effective. "Treatment coverage may even decrease total health care costs because the cost of treatment is outweighed by decreases in other uses of the health care system."
Starr then considers the applicability of the Americans with Disabilities Act to the issue and discusses the litigation potential of the ADA in addiction treatment cases. She finds better hope for bringing about parity in a piece of proposed legislation, the Substance Abuse Treatment Parity Act--but also finds shortcomings in it. In her conclusion, Starr argues that the establishment of parity in coverage of substance abuse treatment is a "first step" toward improved access to addiction treatment. She also writes, "Advocates should work to change misconceptions about the effectiveness and cost-effectiveness of treatment and to transform the public misconception that addicts are criminals or derelicts who have brought their conditions on themselves by choice. Addiction is a serious disease, and its victims deserve understanding, respect, and compassion; they also deserve access to effective medical treatment. In the end, it is a question of simple fairness."