Psychology must help transform a health-care system that focuses
on treating disease into one that concentrates on promoting wellnessand preventing disease
in the first placesaid Russ Newman, PhD, JD, APAs executive director for professional
practice, at the APA Practice Organizations 2007 State Leadership Conference, March 3–6
in Washington, D.C.
In his opening keynote address, Newman advised the nearly 700 conference participants from
states, provinces and territories to use their knowledge and training in human behavior to shift
the focus to helping people lead healthier lives.
Efforts to simply fix the broken health-care system must give way to efforts to truly
create a new one....We must create a new culture to replace old traditions and ways of behaving,
Newman said in discussing the conference theme Positioning for Change: Expanding Psychologys
Roles, Influence and Value.
This years conference was the third consecutive gathering emphasizing the role that
psychology can play in achieving the goal of improved health with controlled, or even lowered costs,
and it again gave participants a chance to talk to policy-makers and members of Congress about psychologys
legislative priorities regarding Medicare and mental health parity.
To illustrate why fundamental changes are needed, Newman cited the human and economic costs
of the current health-care system: By recent estimates, 47 million Americans lack health insurance.
This gap in coverage amounts to $100 billion in medical costs for treating uninsured patients,
often for serious problems that could have been avoided with preventive care.
Nationally, about $1.9 trillion16 percent of the nations gross domestic productis
spent on health care annually, a share projected to increase to 20 percent of gross domestic product
by 2015.
Despite such large expenditures, many people receive less care than they need or the wrong kind
of care, and the Institute of Medicine estimates that 100,000 people die in hospitals every year
because of medical errors, Newman said.
Healthier behavior, better health
Americans contribute to the health-care woes by the ways they cope with stressoften
by smoking, drinking, eating too much and indulging in fast food, Newman noted. As a result, 65 percent
of all U.S. adults are obese or overweight. The obesity trend contributes to the growing prevalence
of diabetes, a condition costing the economy an estimated $132 billion annually.
Given that poor health is often cited by people beset by stress, psychology is drawing attention
to ways people can reduce stress in their lives, through such programs as APAs national Psychologically
Healthy Workplace Awards and the Mind/Body Health Public Education campaign.
The workplace awards recognize employers with organized efforts aimed at creating psychologically
healthy work environments. A survey found that 19 percent of employees at award-winning companies
reported high stress, compared with the national average of 33 percent. The job turnover rate at
those companies was also less than one-third the national average.
Psychologists, said Newman, also need to continue to build relationships with groups outside
of psychology. He cites as an example a program that matches psychologists with municipal employees
who are first-responders in disaster situations. Building a relationship before a high-stress
incident strikes means help will be welcomed when its needed in the aftermath, he said.
This is especially key at a time when the health-care system is changing when the world
is changing, and when we are changing, Newman said.
National efforts
Besides briefing participants on how psychology is addressing national trends in health,
Newman described the APA Practice Organizations efforts to advocate for psychology at
the national level, such as:
The Health Insurance Marketplace Modernization and Affordability Act (HIMMA). Promoted as allowing small businesses to band together for health insurance coverage, HIMMA would
have eliminated mental health consumer protections enacted state-by-state over the past 30 years.
Led by the APA Practice Organization, a grassroots campaign in 2006 generated 19,000 emails opposing
the bill and helped to stop it.
Non-physician health-care professionals. Legislation pushed by the American
Medical Association (AMA) would have prohibited non-physician health-care professionals from
representing themselves as having equivalent education, skills or training to
a medical doctor. Opposing the legislation, Practice argued that doctoral-trained psychologists
have more training than physicians for services they are licensed by state authority to provide.
Medicare payment cuts. Building on similar successes in recent years, the Practice
Organization helped turn back a 5 percent cut in Medicare reimbursement rates for 2007, but is still
fighting a 9 percent cut for Medicare reimbursement imposed by the Centers for Medicare and Medicaid
Services (CMS) five-year review process.
Current procedural terminology (CPT) codes. Practice Directorate staff continues to work
with AMA and CMS staff on appropriate implementation of the new psychological and neuropsychological
testing CPT codes.
Mental health parity. Drawing a comparison with previous years when he said he
was optimistic, hopeful and cautiously optimistic
on passage of comprehensive parity legislation for insurance coverage of mental health services,
Newman described himself as confident that a bill to close loopholes in the current
federal parity law will be passed this year, given the support from key business and insurance sponsors.
State efforts
On the state level, Newman cited progress related to:
Prescriptive authority. In Hawaii, prescriptive authority legislation recently
cleared Senate and House committees, making it possible that this year the state will join Louisiana
and New Mexico in obtaining prescription privileges for psychologists.
California hospital privileges. In the latest development in the struggle to
allow psychologists to treat patients without the oversight of a psychiatrist in state hospitals,
a court ruled that a medical group suing to invalidate state regulations was not entitled to attorneys
fees.