Securing the right to private contracting is a vital goal The American must pursue. It is not, however, all that we must do. Without also pressing for adequate coverage of psychotherapy and psychoanalysis, we are essentially taking the position that we do not provide a service of great benefit to the many patients who are unable to pay for it privately. We must not fall back, willynilly, into the position that psychoanalysis is an elective rather than essential treatment. We must also confront the excesses of managed care, both for the sake of our patients and to protect the livelihood of the many analysts who treat insured patients with psychotherapy and psychoanalysis.
During last year's national health care debate, The American's lobbyist, Daniel Leach, helped orchestrate contact with the legislators and staffers who were crafting the language on mental health for all the key bills. He provided insight into committee politics, apprised us of potential developments, and helped us with presentations to the Senate Working Group on Mental Health. As a result, our efforts had an extraordinary impact in bringing about the expansion of benefits for medically necessary services. We were able to effect a sea change in legislators' appreciation of the efficacy and cost-effectiveness of psychotherapy. Also effected was a growing recognition of the need to limit managed care, a goal also sought in the American Medical Association's Patient Protection Act. Leach lobbied hard, and with considerable success, to incorporate limits on managed care into several bills. He was able to reach both Democrats and Republicans, arranged a breakfast meeting with Senator Robert Packwood that was attended by Judith Schachter and other members of The American, and was able to reach Senator Robert Dole, who planned to mandate coverage for all medically necessary outpatient psychotherapy in the Republican proposal.
This last year, Leach has helped us coordinate our efforts with those of other organizations, including the American Psychological Association, the National Association of Social Workers, and the Mental Health Liaison Group, a coalition of major mental health provider groups. He has been helping to coordinate the agenda of a new national organization, Advocates for Women's Mental Health, which has been brought together by Susan Lazar of The American and includes NOW, the National Women's Law Center, and the Women's Legal Defense Fund. Coalition with these groups, all committed to fighting the abuses of managed care, expands exponentially our efficacy in this fight.
In the nonlobbying arena, Leach's firm was successful in persuading CHAMPUS to reverse its error of underpaying for psychoanalysis over the past year, and obtained retroactive reimbursement. Previously, even the most strenuous and concerted efforts of CGRI had failed to achieve this result.
For a number of reasons we need to maintain a presence in Washington in the months ahead. We want to have an impact when Newt Gingrich holds his promised hearings on the abuses of managed care. We also need to have input in hearings into the Federal Employees Health Benefits Program. That program and other entitlements such as Medicare and CHAMPUS account for more than a third of health care expenditures nationally. The program has been used as a model in the crafting of other health benefits packages, and has lately been improving its mental health care coverage.
Finally, The American's tie with a lobbyist will be essential in furthering our educational initiatives as the battle shifts this year to state legislatures and insurance commissions. As developments occur, CGRI will make every effort to keep the membership informed and effective.
Arthur J. Farley, M.D., chairs The American's Committee on Government Relations and Insurance.