COMMENTARY

Healthcare Reform and Psychiatry's Wish List

Drew Ramsey, MD

Disclosures

August 01, 2017

Drew Ramsey, MD: Healthcare reform is on everyone's mind. I'm Dr Drew Ramsey, reporting from Medscape Psychiatry. I'm here at the annual meeting of the American Psychiatric Association (APA). I spoke with some of the leaders of the organization about healthcare reform and its impact on patients with mental health conditions.

Dr Shah, healthcare reform is on everyone's mind. What is essential to psychiatry when it comes to healthcare reform?

Ravi N. Shah, MD: We have to get insurance companies to adequately reimburse for the care that our psychiatrists and therapists provide. This is critical for patients—not just getting better from their mental health conditions, but also for their overall physical health care.

Dr Ramsey: I'm speaking with Dr Kraus, who's the treasurer of the American Psychiatric [Association] Foundation. Dr Kraus, what are some of the most important issues when it comes to healthcare reform?

Louis J. Kraus, MD: The three most important issues for psychiatry are: (1) issues dealing with preexisting conditions; (2) issues with parity; and (3) the single-payer system. All of these are issues within the Affordable Care Act; all of these are issues that, as psychiatrists, we have to be very concerned about and work in every way we can with the APA in regard to efforts in Congress and on the Hill.

Dr Ramsey: Dr Kraus, if there is one thing you can change about healthcare in America to better serve patients with mental health conditions, what would it be?

Dr Kraus: Parity. There needs to be parity in [mental] health care compared with other areas of medicine.

Dr Ramsey: What is parity?

Dr Kraus: Parity is equal pay. Parity is having somebody with a mental health issue [be able to] get the same services for their mental health issue as if they had a cardiac issue or diabetes or some other medical condition. Mental health issues should be covered in the exact same way as other medical conditions. At the present time, they're not.

Dr Ramsey: Healthcare reform—what's essential for psychiatry?

Elizabeth Hasse, MD: As a small-town-Nevada community psychiatrist, I can tell you that Medicaid has made the difference between repeated admission to hospitals and chronic care for my patients, many of whom have multiple medical problems, multiple psychiatric problems, and are clinging by a thread. If they don't get coverage for their medicine, they're back in the hospital. They also really lose the very, very delicate thread that they have on stability.

Dr Ramsey: If you could wave your magic wand and change American healthcare, what would you do?

Dr Hasse: I would provide Medicaid for all and then a more complex system on top of that.

Dr Ramsey: What's essential for psychiatry in healthcare reform?

Nasir H. Naqvi, MD, PhD: In healthcare reform? Parity.

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