During the past six years, we have seen the effectiveness of our small professional group in its capacity to influence Congress and the White House on matters of vital concern for our patients and our profession. We have done this with relatively little money and a great deal of dedicated work on the part of our members and our legislative counsel, Jim Pyles, and his staff. While we can be proud of the impact we have had, we must also be sobered by the constant march of forces against the basic principles of individual privacy and the right to contract privately in national health legislation. The forces that oppose these vital issues have great wealth and consequent influence.
We can never match their wealth, but we can match their influence by strategically placing a Health Care Fellow inside an appropriate office on Capitol Hill. Other groups, such as the American Psychiatric Association and the American Psychological Association, have one or two fellows on the Hill. The presence of such a fellow can have a marked impact on how legislation is debated and eventually on how it is written. While lobbyists wait in the halls of Congress to peddle their influence, a Health Care Fellow would be inside the offices of representatives or senators and House or Senate committees. Such a person would not just track legislation but would help create it. He or she would be educated in the voice of individual patient rights to privacy and contracting. It must be understood, however, that such a person cannot be influenced by our organizations; that would constitute a conflict of interest.
Over time, we could build a cadre of former Health Care Fellows whose contacts on the Hill would last at least a decade. Such connection and legislative know-how is of great value.
A person who would be accepted for this position should be psychoanalytically trained, or at least psychoanalytically informed. This person would have to be paid a living wage commensurate with current experienced congressional staff. At this time, such a wage is approximately $50,000.
The person selected requires a noninterference memo signed by the backers of the fellowship. The fellowship will be publicized throughout the American's constituent societies, institutes, and foundations. A subcommittee of the Board of the American Psychoanalytic Foundation, headed by Ali Gallagher (member of the Board and a former congressional fellow), would evaluate any applicants, determine suitability and qualifications, and recommend a person to the Board.
The fellowship would not be limited to clinical candidates but could also be offered to the full range of research and special candidates in psychoanalysis. The possibility of granting a fellowship to a psychoanalytically informed but untrained individual would have to be considered by the subcommittee.
The fellow will report to the Executive Council annually about the spectrum of legislation and issues before Congress. She or he will also write a TAP article from time to time.
The American Psychoanalytic Foundation welcomes comments on this plan. E-mail Harvey L. Rich, president of the foundation, at .