Several years ago, our youngest son Lucas interned with Larry Summers and Tim Geithner, the core of President Barak Obama's economic transition team. Lucas called me one evening and, in the most enthusiastic tone possible, explained that they had arrived upon a plan to erase the $1.3 trillion budget deficit that Obama's administration had inherited. "What was the plan?" I asked. "Papa, we are going to develop a plan to provide health-care coverage to 34 million uninsured people." "How do you add so many people to the insurance rolls and bring down the deficit?" I asked. He responded, "The devil is in the details."
It can be argued that the Affordable Care Act (ACA) was more about economics and health-insurance reform than health-care reform. The ACA offered a way to reduce health-care costs, which had been rising at an unsustainable rate. Significant authority was granted to the states to interpret and implement the law to help to achieve this goal. After all, the nation's health-care costs had been projected to become an unsustainable portion of our economy by 2020.
With the new administration and a Republican Congress, Obamacare is likely to be repealed. Its replacement is yet undefined but is expected to evolve in the coming months. There is no question that the ACA had limitations and further improving America's health-care system is in everyone's best interest.
Psychology has much to contribute to the development of a new national health-care policy based on the goals of increased efficiency and decreased costs. Here are five proposals for the new Congress and administration to consider:
- No one should be denied access to basic mental and behavioral health care.
- Mental health should be considered equal to and, in some cases, even more important than physical health. It is in society's best interest that mental health be seen as essential to health care.
- Mental and behavioral health services must be integrated with, and offered at parity with, physical health services.
- Psychology, with the unique value added from the profession's evidence-based foundation, should be infused in all aspects of health care. This offers a direct and efficient way to both increase effectiveness and reduce costs.
- Psychology should be included in the physician definition of Medicare. We are the only doctorate-level provider not included in the definition. It's time to correct that omission.
Let us embrace today's uncertainty about health-care policy as our profession's and nation's opportunity. And let us reframe our health-care system to fully become "Our Nation's Care."
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