A Question for the Surgeon General


Carl Hendel, M.D. 4/15/99


Many people in our country are afflicted by illness. Many of these people have significant psychological and psychiatric conditions. Our government position on mental health seems to enable discrimination.

There are two common Medicare responses about payments for psychiatric care. One is the "Psychiatric Reduction." This means that the Medicare coverage benefit is automatically cut in half! The result is that a patient is required to pay this significant amount out of pocket if he/she plans to receive the indicated care. Many people cannot afford to do so. Poverty discriminates against many Americans.

The other common Medicare response is "not deemed medically necessary by payer." What I find interesting is that the doctor, patient, and everybody but the payer feel that the care is appropriate and indicated. This decision is made from many levels of bureaucracy away, and the ability to appeal becomes impractical.

The question? Is it reasonable and fair for only wealthy Americans to be able to receive the psychiatric care they need?

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