The effort to overcome political obstacles in Congress to enacting
far-reaching health care reform this fall has drawn the support of a broad
spectrum of advocates, including mental health organizations.
Several of these organizations have urged their members and others to
participate in the increasingly contentious national debate over health care
reform. These efforts have included providing public information on the
mental-health-related aspects of reform bills under consideration and
coordinating campaigns to win passage of health care reform legislation.
APA has undertaken efforts to inform its members of various legislative
proposals under consideration, including weekly updates on legislative
developments from its Department of Government Relations (DGR). A special
health reform update sent via e-mail urged psychiatrists to attend their local
town-hall meetings with members of Congress and "share support for
crucial provisions ensuring access to coverage and reforming Medicare payment
for physicians." Moreover, Psychiatric News has run in-depth
coverage in each issue since health care reform first appeared on the new
Nicholas Meyers, director of DGR, added that APA is targeting its
legislative advocacy to areas where the most direct impact on patients and
members can be realized. For example, APA joined with the Bazelon Center for
Mental Health Law in highlighting loopholes in proposed legislation in the
Senate Committee on Health, Education, Labor, and Pensions that could have
substantially undermined last year's mental health parity law. The problem was
addressed by subsequent legislative changes. Other areas of attention include
workforce and reimbursement.
Rep. Jim Moran (D-Va.) tells attendees at a contentious town-hall
meeting in Northern Virginia last month that the health care overhaul should
include coverage for mental health care. "These are services that anyone
[with insurance] should expect," he said.
Credit: Rich Daly
Many town-hall meetings held this past summer by members of Congress drew
national media coverage when angry constituents loudly protested expansions in
the power and cost of government that health reform could bring (see
Health Care Reform Becoming a Steeper Climb).
The negative reactions at the
meetings went hand in hand with dropping public support for the effort. An
August Kaiser Family Foundation poll found that the portion of the public who
thought that the nation as a whole would benefit from reform dropped to 45
percent from 51 percent in the preceding month.
But health care reform supporters felt encouraged at some town-hall
meetings. At two such events led by President Obama in July and August,
members of the public specifically asked Obama about the inclusion of mental
health care in health care reform, and he expressed support for it.
"I've long been a supporter of mental health services as part of a
package, and I think that's important," Obama said at a town-hall
meeting in Shaker Heights, Ohio, in July. Obama also called for more
Mental health advocates said that their efforts to expand access to mental
health care has a proven record of effectiveness.
"We were successful in enacting mental health parity, and grass-roots
advocacy was an important part of that," said Steve Vetzner, a
spokesperson for Mental Health America.
The parity law enacted in 2008, known as the Paul Wellstone and Pete
Domenici Mental Health Parity and Addiction Equity Act, requires health plans
that cover 50 or more workers and offer mental health benefits to have the
same service coverage and payment requirements as those for other health
Chris Koyanagi, a policy director at the Bazelon Center for Mental Health
Law, said people with an interest in improving access to mental health care
should engage in the health reform debate. Earlier in the summer, the Bazelon
Center had focused on sending updates to supporters on features of various
health reform bills, but in recent weeks the center began to urge them to take
action to support reform.
"It's much more important that people who want reform be heard from
at this stage, given the noise from the people who don't" want reform,
The strongly held objections of health reform critics expressed at
town-hall meetings about the high costs and expanded government role in health
care parallel the reform-related advertising campaigns that are unprecedented
in their size and scope. Nationwide, more than $57 million has been spent this
year through August on advertising related to health care reform, according to
media reports. At $48 million, proponents have far outspent opponents.
The spending is set to increase dramatically as Congress again takes up
consideration of a health care reform package this month. Some of the funds
will come from the AMA as a member of the new pro-reform coalition called
Americans for Stable Quality Care. Other members include the Federation of
American Hospitals, the Pharmaceutical Research and Manufacturers of America
(PhRMA), and the Service Employees International Union. The coalition
announced plans in August to spend $12 million on a television advertising
campaign aimed at winning support for current health reform plans.
PhRMA's spending on TV ads is expected to increase to a total of $150
million this fall, according to media reports. By way of comparison, the 2008
presidential campaign of Sen. John McCain spent $126 million on television
The Bazelon Center's information on health care reform and its
advocacy efforts is posted at<www.bazelon.org/issues/healthreform/index.htm>.
APA's information is posted at<www.psych.org/MainMenu/AdvocacyGovernmentRelations/GovernmentRelations.aspx>.
Mental Health America's information is posted at<www.nmha.org/>.▪