I got carried away in the last post and added this as supplementary information. Sometimes I forget that this is a blog and not a research paper in Nature. So here is the suggested 4" x 6" note card that is all that is required to reform an out-of-control managed care industry. It is more out of control with regard to psychiatric and mental health services than any other health care services and some of the reasons were given in my previous post. The additional data is contained in this blog and the obvious places to look have to do with jails being the largest providers of mental health services, per capita psychiatric beds being at lower numbers than most OECD countries, overcrowded emergency departments due to the lack of available psychiatric beds and less intense psychiatric facilities, the lack of psychotherapy services. the lack of state-of-the-art psychiatric evaluation facilities, the lack of structured facilities for children with psychiatric problems, a lack of detox facilities, and a serious lack of treatment facilities for substance use disorders.
In one way or another - all of these services are casualties of managed care.
The 4" x 6" card is all that is needed to regain a focus on quality care and starting to develop adequate services again. As we have recently seen - 300 page rewrites of health care law that are unreadable and contain a line for every business Congress wants to fund accomplish nothing. Print off the card and spread the word.
Anything short of these basics is just special interest politics as usual. In politics the excess usually means coming up short.
George Dawson, MD, DFAPA