The
Caucus met at the last APA Meeting in New Orleans! (Photo: Dr. Ed de
la Cruz).
We are unsure at this point... (11/11/2001)
At this point we are not sure about the fate
and the success of the Caucus. We are planning to have a meeting of the
Caucus in the APA meeting in Philadelphia in May, 2002. At the same time
the APA Assembly continues to try to move a motion in the direction that
the APA opposes any carve-out of mental health services (private and public).
What is at stake here is the US health care system that remains centered
on the employer and on the health corporations and that - so far - denies
the physicians the right to organize and get together to have a common
voice for themselves and their patients. This is a process that will take
a long time to reach its goals. But in America we trust the eventually
the people will will and will have the health care system that they deserve.
Corporate health places profits and dividends ahead of good care and proper
compensation for doctors. They also continue to strive to maintain their
protection in the law, being not liable for poor patients' care. We just
must keep moving...
THE CAUCUS WILL MEET AGAIN IN THE INSTITUTE
OF PSYCHIATRIC SERVICES IN ORLANDO!!!
The
Caucus met at the last APA Meeting in New Orleans! (Photo: Dr. Ed de
la Cruz).
The Caucus is growing... so is the revolt inside
the APA against Behavioral Managed Care (4/17/2001)
The Caucus For Psychiatrists Working With Patients
Covered By Managed Care is growing. It now has 43
registered members, and its own list serv.
The Caucus is going to meet in New Orleans in the next Annual
Meeting of the American Psychiatric Association.
If you are a member of the APA please contact Karen
Sanders at ksanders@psych.org to register for
the Caucus.
Another good news! Sort of... (1/14/2001)
The Board of Trustees of the American Psychiatric
Association approved an action paper, and took a position opposing private
sector carve outs. This was long due. It is incomprehensible that mental
health care remains separated from health care in general, and given to
for
profit behavior mental health corporations! The only problem is that
someone or a few voices in the Board of Trustees managed to exclude
public
carve outs from the Board's decision. This is unfortunate. Our hope
is that the Board will correct this exception, and oppose ALL CARVE OUTS
because they have done more harm than good when it comes to proper patients'
care, private and PUBLIC.
The Caucus is taking shape (9/13/2000)
The Caucus for Psychiatrists Who Work With Patients
Covered by Managed Care Corporations, is taking shape. There are now many
psychiatrists who are registered. The requirement is simple: any clinical
psychiatrist who treats patients covered by Managed Care. Anyone else connected,
employed, associated in any way with the Managed Care Organizations
will not be welcome at this time. We are going
to have our own List Serv and we will be meeting in Philadelphia on Oct.
27 in the Annual Meeting of Psychiatric Services. Will keep you all posted.
The Caucus met the first time! (05/26/2000)
In the APA Meeting in Chicago, on 5/16/2000, the Caucus of Psychiatrists
Who Work with Managed Care Patients met for the first time. It was a good
meeting and the attendance was better than we expected. We discussed many
shared experiences and issues dealing with patients who have health insurance
and are carved out to Mental Health Managed Care Corporations. The APA
is giving us support. I am very thankful for this. Many officers of the
APA were present. This is very good news I am hoping that we are starting
a movement that will give voice to front line psychiatrists who
work with insured patients. Here
is how I see the need for this Caucus.
I am sure now! Good news! (4/18/2000)
The APA will indeed have the first Caucus For
Psychiatrists Working with Managed Care Patients. This, I hope, will be
the beginning of movement of psychiatrists who are treating Managed
Care patients in their offices. The Caucus is scheduled for May 16, Tuesday
from 9 AM to 11 AM at the Convention Center, McCormick Place, Lakeside,
room E267, Level 2. By allowing this Caucus to convene the APA is opening
its doors to front line "providers" who want to get together to share experiences
and views on how to deal with Managed Care. THE APA IS CHANGING! GOOD!
I am not so sure about the Caucus... (3/12/2000)
I am not so sure about the Caucus. We are in
March but up to know I have not heard that there is a place for the Caucus
to meet in Chicago. Also it will be difficult to let the membership know
about this Caucus. Finally I am not sure how popular this will be with
the membership. It seems - but I am not sure - that many members of the
APA see this Caucus as a form of condoning the MCOs and working with them.
They seem to feel that the best course of action is to resign from the
MCO panels and work privately. They also seem to be in favor of MSAs. I
am not so sure because I believe that the majority of the American people
want to share the costs of health care, and have access to good treatment.
This is why they buy health insurance. But the mental health sector is
carved out to Behavior Managed Care Corporations For Profit, and it is
becoming very difficult to treat patients under their restraints and constraints.
Better News!!! (1/2/2000)
Happy New Year to all. Here is the better, much
better news! The Board of Trustees of the American Psychiatric Association
has approved the Creation of a CAUCUS OF PSYCHIATRISTS WORKING WITH MANAGED
CARE PATIENTS. Finally we will able to meet and to share ideas about
working with insured patients. To what extent it is possible working with
patients covered by managed care, when this becomes unethical and what
we want to change to keep our honorable profession and the respect of
the doctor-patient relationship. Most likely in the next APA meeting in
Chicago this Caucus will meet for the first time.
Good News (12/9/99)
The Assembly of the American Psychiatric Association
approved an Action Paper that will create a Caucus for Psychiatrists Working
With Patients Covered By Managed Care Patients within the APA. We are now
waiting for the Board to approve it. But, guess what? The votes in the
Board are secret... Will wait and see. Will let you all know.
Continue to be perplexed... (10/9/99)
I have been defeated in my attempts to create
a Caucus of MCO psychiatrists. In the mean time 60% of the American people
is under Managed Care. A large number of psychiatrists, not necessarily
by choice, is working with Managed Care patients. The only problem is that
we have been - so far - unable to get together and to form a cohesive group.
The APA is dreaming of Medical Savings Accounts and Catastrophic Insurance
(most likely with Managed Care). In the mean time MCOs are growing and
growing and we, "providers", have not be able to organize themselves in
the Association. The APA has Caucus for everybody else... Puzzled!
I am perplexed... (9/13/99)
I have been trying for start a Caucus of Psychiatrists
who work with Managed Care patients. I believe the number of psychiatrists
who are providers for managed care is increasing a lot. I thought that
we should get together as a group to exchange ideas and to have a say and
a voice about the conditions under which we will or will not work. Although
there are many APA members who agree with me, the official organization
has systematically blocked my attempts to form this Caucus. I have no idea
about why. Would we, as psychiatrists, be stronger if we organize ourselves
to stand up - as a group - against the managed care industry? If the APA
is against managed care why we are not being supported in this endeavor?
Were are the AMA and the APA going?... (09/12/99)
The AMA and the APA are moving towards Medical Savings Accounts and
Catastrophic Insurance. They say that this "empower the patients" but in
reality, from our way of seeing things, this empowers the doctors, the
healthy, the young and the wealthy. It also empowers the Catastrophic Insurance
Corporations that will be able to offer a "product" with a high deductible.
Of course, the higher the tax bracket of the citizens, the bigger the tax
brake. It is not clear how such a system will deal with the citizens who
can't have a medical savings account, spent his savings or can't buy insurance.
I don't know about you, but as I think about society and the well being
of the population. I continue to believe that the Canadians found
the right formula. Their system is not perfect but there, yes, the citizen
is empowered because he can chose his doctor, and because he negotiate
the doctors' fees through a Provincial Council.
EVEN BETTER NEWS!!
The Board of Trustees of the American
Psychiatric Association voted (unanimity) to endorse the Adhoc
Committee to Defend Health Care "Call to Action". Needles to
say, I am becoming proud to belong to both organizations!!
Very good news!
The Assembly of the American
Psychiatric Association approved an Action Paper to endorse
the Adhoc Committee to Defend
Health Care on 11/7/98.. Finally the APA is taking a stand!!!
As I write these notes...
The American Psychiatric Association still has
not taken a clear stand on the question of a good health care system for
the American people. I think that a professional organization like the
APA could be doing better. It should be very involved in promoting the
best health care system for the American people.
Where is my professional organization, the American Psychiatric Organization?
I am trying to figure out where the American
Psychiatric Association stands in terms of the present health care
system in America. Yes, I know that this Association has a lot of diversity
among its members. Hence it may be difficult for it to take a stand
in terms of the issues psychiatry is facing now. I know there is a lot
of dissatisfaction among its members.
Let me guess...
A large contingent of members believe in "private practice" that is, patients paying out of pocket for their services. I agree that this private care in psychiatry may be the best for doctors and patients. But I am concerned that a large portion of the population is not able to go private and is very much afraid of the doctors' bills.
Some of these private psychiatrists don't mind being "non participant providers" with the HMOs. This usually means that the patient does the paper work and can be charged beyond what the insurance will pay the doctor. Usually this group is also in favor of Medical Savings Accounts.
Although the APA is against HMOs and Managed Care it doesn't seem to be too interested in confronting these organizations. These private doctors feel that they will offer better services than the HMOs/MCOs. Because of that, people will chose them. Of course, the HMOs and Managed Care are also glad that these psychiatrists are around because the patients will still pay their premiums, and will cost less to them.
I suppose that among the membership in the APA some are in favor of a Single Payer, similar to what the Canadians have. But I don't know how many and even if they are a substantial number.
Disappointment!!!
This kind of discourages me. When I am thinking
that the American Psychiatric Association is helping us to stand up against
Managed Care, after hearing speeches of the past and present presidents
taking a strong position against these organizations, I found this:
The NCQA , an organization created by the Managed Care Organizations to legitimize and accredit their operations, that a representative of the American Psychiatric Association is a member of their "Practicing Physicians Advisory Council"!
So, my professional organization is an advisor to Managed Care!
Discouraging!...
Strange bedfellows
But come to think, maybe things are like this for good reasons. Let's
think... The private psychiatrists are very pleased when Managed Care makes
it impossible for patients to have proper treatment. Why? Because they
will say: "Come to me, pay more, and I will do a better job" So, the worse
the Managed Care treatments are, the better are their chances to have patients
paying out of pocket. On their side, Managed Care Corporations of course
will love when their insured patients go to a private doctor and pays out
of pocket. Why?... Because they will be collecting their premiums, and
will not spend money in their treatments.
So, they are not such strange bed fellows as they seem. Some private professionals treat people only as non participant providers or fee for service patients.