Healthcare Reform… What About Us?
Healthcare Reform… What About Us?
In recent times, there have been extraordinary events that put a pause on routine and threw our country into animated conversation but they have mostly been about bad news – 9/11, the invasion of Iraq and most recently the Wall Street bailout. The election was neither bad news nor a distraction like a celebrity meltdown, it actually mattered. And as a result of this incredible election season, America?s children have a chance to grow up unaware that there?s anything unusual about an African-American President or a woman running for the White House.
2008 Legislative Success
Now, it?s over – the excitement, the soaring and in some cases snoring oration, the primaries and the debates – the Presidential campaigns are over. It was my great good fortune to attend the Democratic National Convention and to have affirmed in speeches and by actions that our community has indeed made progress. We had Senator Kennedy?s bittersweet appearance and his steadfast commitment that was so critical to the passage of parity; Michelle Obama?s unexpected reference to mental health when she talked about universal healthcare; Bill Clinton?s description of a mom struggling with her sons? autism; the first ever “recovery room” at a convention; and a luncheon honoring the Campaign for Mental Health Reform that included A list celebrities as well as national and state political leaders all vocal in their support of accessible, affordable mental health and addiction treatments.
The rhetoric of the convention was matched by an extremely successful legislative year: the delay of damaging Medicaid rules on rehabilitative services and targeted case management and the introduction of the Medicaid Services Restoration Act; the passage of Medicare parity; veterans legislation that extends mental health and addictions services beyond the VA out to communities; improved collaboration between criminal justice and mental health; expansion of the disability definition in the ADA making it easier for people with disabilities to obtain protection against disability-based discrimination; and the passage of parity ending health insurance discrimination.
It is a hopeful time for people with disabilities. Our string of legislative and policy successes reflects tremendous progress. And substance use and mental health advocates – united by the Presidential campaign – can share a path forward into a new era.
The Economy and Service Capacity
But times are tough in communities across the country – and the world, people losing their jobs, their homes and their retirement savings. Many of us at the National Council have spent these last few months traveling from state to state and community to community. And we return from these trips filled with anxiety.
As states attempt to manage their budgets in a very fragile economy, increased demand for mental health services could be on a collision course with impending cuts to publicly funded services. Our already tattered mental health and addictions safety net is in grave danger of collapsing as unemployment rates soar, anxiety over the future grows and demand for services is at an all time high.
We urge states to resist cutting essential mental health and addictions services and we?re lobbying for federal stimulus packages that include Medicaid relief and financial supports so that communities can meet treatment demand in the difficult months and perhaps years ahead. At the same time, our industry -the behavioral healthcare industry – has to be ready to work with the greatest efficiencies and be accountable for every taxpayer dollar. And the National Council?s proud of the initiatives – our Access and Retention, Six Sigma and Process Benchmarking projects -that we?ve introduced to support member efforts to streamline access, creating more treatment capacity and more effectively engaging consumers and communities in the recovery process.
Our Role in a Progressive Era
Now the question being asked is what?s our role in a new administration, in a new era? One of President elect Obama?s challenges will be to harness the extraordinary idealism that he inspired in his campaign to a larger, national cause. We appear to be leaving behind the conservative agenda and entering a progressive era. A progressive era being shaped by the millenniums with their internet culture and by a new breed of the very rich that are using their wealth to support progressive causes and demanding accountability in return for philanthropy.
But even in a new era, the reality, pace or shape of healthcare reform – is uncertain. Washington is already abuzz with health care groups lobbying their points of view and potential candidates for healthcare posts in the new administration polishing their resumes. But economics, politics, and history suggest that any major overhaul of our healthcare delivery system will be a difficult process