I think the figure I heard yesterday about the amount the United States spends on health care today was $2.6 trillion annually. That’s a lot of zeros! And hard to get my mind around. What it does tell me is that no matter who wins control of the White House and the two chambers of Congress, our current system must and will change dramatically. One expert who addressed our group said that unless the rate of health care cost growth is arrested, the cost of care per employee will exceed wages over the next decade or so. That cannot and will not happen.
Some colleagues advocate for a single-payer system, which might be our ultimate destination. The Affordable Care Act is relatively conservative but will definitely bring big change. Even if conservative forces prevail politically, the market will force change. The change will inevitably involve greater focus on efficiency, effectiveness, evidence-based treatments, and long-term management of patients with chronic illness. Behavioral and psychiatric conditions will ascend in importance. Information technology—for medical records, communication among clinicians and with patients, decision support, and patient education and adherence—will take on growing importance.
Change is inevitable and imminent. Psychiatrists and other physicians must stay attuned and prepared for the implications of change on their lives and practices.
-Alan J. Gelenberg, M.D.
Editor, Biological Therapies in Psychiatry
Shively/Tan Professor and Chair, Psychiatry, Penn State University
Editor-in-Chief, Journal of Clinical Psychiatry