The Devil We Know and Health Care Reform or “How does knowing you don’t need to worry about having health insurance make you feel?”
I am not a counselor. Nevertheless, having worked as a lobbyist for the American Counseling Association for the past fourteen years, I’ve learned a little bit about how counseling works, and one of the tenets I’ve heard more than once is that change is scary. My recent work for ACA on health care policy bears this out in spades.
One of our top legislative priorities has been establishing Medicare coverage of state-licensed professional counselors. Although we’ve come close to achieving this goal before, we’ve never been as close to success as we are now, following House passage of health insurance reform legislation including Medicare coverage of counselors and of marriage and family therapist. We were glad that House members recognized that Medicare beneficiaries need better access to outpatient mental health care, and that licensed professional counselors and MFTs are qualified to provide psychotherapy.
Consequently, it surprised us when, as soon as the House legislation was unveiled, it was vociferously attacked for, among other things, “government intervention in marriage.” Why? Because it included our provision. Following a slew of disinformation—anyone remember “death panels”?—spread by those who prefer the status quo, angry attendees started showing up at town hall meetings with signs saying things like “Keep government out of my Medicare!”. While attacks like these—including on our provision—were disappointing, both the House and Senate ultimately passed comprehensive bills, one with our Medicare provision (the House bill) and one without (the Senate’s).
ACA has long supported establishing universal access to health insurance coverage, and the bills approved by the House and the Senate would cover an estimated 96% of legal residents. Both bills include several provisions to reduce the growth in health care spending, and despite what you may have heard, both bills retain our current reliance on private health insurance coverage.
Many people, including counselors, dislike the health care legislation, and I’ve heard from a few of them. Those opposing the health care legislation in general can still help by contacting their Representative and Senators to talk to them about Medicare coverage of counselors. However, there are four things that I encourage people to keep in mind.
1) The status quo is not an option. Some analysts have complained that the health reform legislation would bankrupt the country. On the contrary, the current system is bankrupting the country; the health care reform bills would actually reduce the federal deficit.
2) None of the politicians attacking the health care legislation has yet put forward a real, comprehensive proposal which would ensure that all Americans—or even 96%—are insured.
3) Health care policy is like a balloon. You can’t make a few changes in our health care system in one place and leave it at that; it’s all connected, so a comprehensive approach isn’t just a virtue, it’s a necessity.
4) Medicare coverage of counselors, if and when it happens, will be part of much broader health and/or Medicare legislation. We’ll never have the luxury of supporting just our own little provision.
The bottom line is that we need change, and that change is scary (especially when those with a financial stake in the current system fan the flames!). That doesn’t mean we can’t—or shouldn’t—change.
ACA encourages counselors to contact their members of Congress to ask them to get the job done, and enact comprehensive health reform legislation as soon as possible. In the meantime, I encourage readers to email me with specific questions or concerns regarding the legislation.
Lastly, this slide compares per capita health care spending in the U.S. versus other developed countries. It’s pretty sobering http://facts.kff.org/chartbooks_pdf.cfm?ch=359.
Scott Barstow can be reached at sbarstow@counseling.org.
