Health Care, National Health Insurance, and Psychology.

The role of psychologists as health care providers and the parameters of reimbursement for health care services are timely and controversial issues. A landmark decision was reached in this controversy in the 1980 appeal of a Virginia suit by clinical psychologists in which the court ruled that Blue Shield's refusal to directly reimburse psychologists was a violation of antitrust law. Thus, the requirement that psychologists bill through physicians was not upheld. In recent years a specific aspect of this controversy involved psychologists' roles in potential national health insurance programs. A limited study (appearing in the "National Register of Health Services Providers in Psychology" 1976-1978) of clinical psychologists' attitudes toward national health insurance suggests that Congress and psychologists may have disparate views. In addition to favoring national health insurance, over 85% of psychologists surveyed responded that consumers would benefit from such a program with mental health coverage. Only 16% agreed that such a program would constitute a subsidy of the rich by the poor (Albee, 1977). Several areas of conflicting or confusing responses in this study may reflect legitimate reasons for concern by Congress regarding institution of national health insurance. Belief that providers would benefit from mental health coverage in a national health insurance program was shared by 80% of respondents. Ninety-five percent of respondents identified the inclusion or exclusion of clinical psychologists in such a national health insurance as affecting the future of the profession. Curiously, over 50% of respondents agreed that primary care physicians should be reimbursed for mental health services, although such physicians have received no formal training in psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)