The Second Edition of the text The Promise of Group Therapy: How to Build a Vigorous Training Base for Group Therapy in Managed Behavioral Healthcare will be published on-line by THERAVIVE, a well known directory of therapists and their practices. The book will be re-published sequentially, one chapter at a time. It will have a new introduction that I give below.
When I wrote the First Edition of this text 14 years ago, I was overly optimistic in my assumption that corporate medicine would adopt the common sense notion that a skillful combination of 1) capitation, 2) utilization of less labor intensive treatment methods (group and family therapy), and 3) highly trained clinicians would both serve a growing population of patients in need of mental health treatment and reduce medical costs. In addition, an effective organization would develop avenues of communication and coordination between the three essential components of a health care delivery system: An administration that implements sound principles of organization development in the service of comprehensive patient care, a staff of highly trained clinical professionals dedicated to patient education and preventive care, and a Board of consumers who advocate for patient benefits and encourage patients to take an active role in their own self care. Unfortunately and ironically, corporate medicine and its health insurance partners failed to develop the appropriate organizational structure and competent personnel in a context of ongoing professional training that would have led to such a successful operation and felicitous outcome for patients and their doctors. Instead, the medical-health insurance industry pursued a for profit path serving the interests of their investors and highly paid management.
It did not have to come to this. In the absence of public control and in the face of rising medical costs, employers and insurance companies set about to establish a system to manage costs. But they failed to do so. The transfer of public services and consumer dollars to the administrative control and ownership of private insurance corporations have diminished the buying power of both employers and consumers and led to the present impasse.
It is now abundantly clear that the corporate medicine-health insurance alliance must be dissolved, and the funds that keep it alive channeled to a single payer health insurance system that will adopt the skillful and frugal policy that I describe above. Although the cost of technology and research are much higher in the delivery of medical treatment than mental health, the implementation of preventive care and capitation (health benefits guaranteed at a predetermined price per person) are powerful incentives to be creative and innovative in the delivery of both kinds of care. Indeed, the appropriate and timely delivery of mental health care to individuals in need can substantially reduce medical costs. The converse is also true: the appropriate and timely delivery of medical care to those in need can reduce mental suffering and expense.
The First Edition methods and recommendations for the delivery of mental health treatment of large populations still apply. But now I am addressing a different audience. Instead of corporate managers of private behavioral health plans, I am now speaking to the managers of the single payer health plan that will emerge in the United States within the next generation. I wish them well, and trust they will not ignore the common sense notion that has energized the prepaid , nonprofit health plans in the United States for nearly a century.
Look here for updates on how to access the contents of this book free of charge.
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