Broad parameters of health care reform take shape

While action on health care reform is not as rapid as some had predicted with the new Congress and Administration, some parameters for reform have been identified

by Government Relations Staff

February 19, 2009 — President Obama has identified electronic health information technology (HIT) systems as a cornerstone of his health care reform plan. Although Congress shares the president's commitment to making health care reform a priority, apart from enacting the HITECH Act with its focus on HIT as part of the recent economic stimulus package, health care reform is not yet moving as quickly as some had anticipated. Yet certain broad parameters of what the Administration and legislators envision have taken form.

Health care reform is not expected to result in a single-payer system that ensures universal health coverage. Rather, employer-based health insurance coverage would be preserved. Coverage of the uninsured and underinsured would be accomplished by expanding current federal programs, primarily Medicare and Medicaid.

A national insurance pool would be created so that small businesses and self-employed individuals can purchase health insurance coverage. Among its advocacy efforts, the APA Practice Organization (APAPO) will seek the inclusion of comprehensive mental health and substance use services at parity with physical health services in benefits packages created through a national insurance pool.

Sen. Max Baucus (D-MT), chairman of the Finance Committee, staked out where he wants to the lead the Senate with the November 2008 release of a 90-page white paper on health care reform. It focuses on preventive services as a way to reduce health care costs, while also giving prominence to primary care and integrated treatment. (See the document file at the end of this article for a summary of key provisions of the Baucus plan.)

The APA Practice Organization will advocate for psychologists and psychological services to be fully integrated in health care reform initiatives that strengthen the role of primary care in the health system. "By virtue of their education, training and professional experience, psychologists are uniquely qualified to play important roles in primary-care settings," says APA Executive Director for Professional Practice Katherine C. Nordal, PhD.

Meanwhile, the principles for reform approved by the APA Council in 2007 assert that "basic health care services include appropriate prevention services that address the role that behavior plays in seven of the ten leading causes of mortality and morbidity." Advocates for professional psychology will work to ensure that screening for depression and other critical preventive services are included in a reform plan. Dr. Nordal observes that, "Psychologists are the experts in working with patients to change behaviors that adversely affect health."

Though all indicate that reform is a high priority for action in 2009, no committee chairman in the House of Representatives has yet proposed an outline for a health care reform bill.

Psychology leaders from throughout the United States and Canada who participate in the March 2009 APA Practice Organization State Leadership Conference will take messages about health care reform to meetings on Capitol Hill. Conference participants will encourage their elected officials and staff to pass health reform that integrates psychological services in primary care, preventive services and benefit packages.