Last summer the U.S. Supreme Court upheld the Affordable Care Act (ACA). Yesterday’s re-election of President Barack Obama virtually guarantees that ACA will be implemented. The process will be long, complex, with countless moving parts. Many of its features require interpretation, further enabling policies from the HHS Secretary, individual state actions, and a myriad of detailed steps. But the continuing escalation of healthcare costs is unsustainable—especially when we are not buying improved care for our citizens. And we can now see a path forward.
Within a few years, almost all who reside within our borders will be eligible for medical care. Mental and behavioral diagnoses will be covered. With the increased focus on efficiencies, behavior will become paramount: enhancing patients’ understanding of their conditions and care, securing their buy-in to treatments, prompting them (often electronically) to take medicine, come to appointments, and more. Recognizing and effectively treating depression, for example, will improve outcomes and save costs in treating diabetes, heart disease, and many other chronic illnesses. I sincerely hope the chronically mentally ill will begin to receive the medical care that has often been denied them—with safe integration of brain treatments and those for other body organs.
Doctors will experience a sea change. The premium for surgery and invasive procedures will give way to preventive and long-term management foci. Information technology will play a growing role in every aspect of health care. Teams of professionals will be integral in the new order.
It will take a long while to “get it right.” The journey will require patience and efforts at every level. But I am convinced we will get to a better place.
-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