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How Healthcare Reform Could End the Stepchild Status of Primary and Behavioral Healthcare: A Talk with AAFP Board Chair Dr. Ted Epperly

BHC

Ted Epperly, M.D., FAAFP, a family physician in Boise, Idaho, who follows a patient-centered medical home model of care that incorporates behavioral health, is board chair of the American Academy of Family Physicians. In recent months, he has spoken with President Obama on several occasions about his concern related to the shortage in primary care and the incentives (or lack of incentives) our country offers medical students to consider primary care. He says that primary care and behavioral healthcare providers have been considered 'stepchildren' in the past, but that he’s confident healthcare reform efforts in Congress could provide some remedy.

Dr. Epperly wrote in an AAFP statement earlier this year, “If America is to right the ship of health care and turn it toward a system of higher quality, improved efficiency, better outcomes, less cost, and decreased geographic and ethnic disparity, it must increase the number of primary care physicians. We cannot meet that goal without dramatically changing the policies that affect our medical education system, graduate medical education and the incentives that draw students to careers in primary care. This decline has nothing to do with the value of primary care and everything to do with a system that claims to support primary care but fails to actually act on its pronouncements.”

Dr. Epperly speaks with BHC today about these important issues facing primary care and behavioral healthcare providers.

GOP and Democrats Agree Health Overhaul Not Dead

WSJ

WASHINGTON — Democrats and Republicans agreed on Sunday that President Barack Obama’s health overhaul wasn’t dead. They disagreed over whether that was a good thing.

Democrats portrayed the health-care effort as a valiant crusade that had suffered a setback but could return to life. “We’re still inside the five-yard line,” White House spokesman Robert Gibbs said Sunday on CNN’s “State of the Union.” “We’re one vote away in the House of Representatives from making health-care reform a reality.”

He added, “The president is ready, willing and able to sit down and listen to Republican ideas for how we improve the health-care bill.”

House Minority Leader John Boehner (R., Ohio) made the overhaul sound more like a corpse that refused to die.

“We’ve seen all week Speaker [Nancy] Pelosi, Majority Leader [Harry] Reid continuing to scheme and plot, trying to find some way to get their big-government takeover of health care enacted,” Boehner said on NBC’s “Meet the Press.” “I do think they are having problems, but I think Republicans are going to continue to be vigilant.”

Republicans insisted they want change — “No one in Washington thinks our health-care system is perfect, and certainly not Republicans,” Boehner said — while Democrats said parts of the legislation would have to be changed.

Secretary Sebelius Comments on Mental Health and the Importance of Integration and Collaboration

Thank you, Steve, for that introduction.  Steve and I go way back.  We served together on a Clinton Administration commission on improving quality in our health care system.  And one of the best parts of that experience was getting to meet Steve and learn about the great work he’s doing here at Sheppard Pratt.  Steve has a passion for trying to do health care better.  And that’s reflected in Sheppard Pratt, which has become a model for how to provide effective mental health services, not just in this area, but in the entire country. 

I also have to mention Steve’s greatest accomplishment in my opinion, which was raising an incredible son named Josh, who’s now our Principal Deputy Commissioner at the Food and Drug Association.  So I have to thank Steve for that.

I also want to add my own praise for Secretary Colmers.  I’m not going to try to top what Steve just said.  But I can say that this fall, I’ve gotten to work closely with state health secretaries around the country on fighting the H1N1 flu.  And I can tell you that Secretary Colmers is doing a great job.  A couple months ago, I was up in Maryland at a school-based flu clinic.  This was right at the beginning of flu season, and I was very impressed by how quickly they had this clinic set up to get kids vaccinated.  So I’m a fan of Secretary Colmers’ work too.

Finally, I want to acknowledge Pam Hyde, our new Administrator for the Substance Abuse and Mental Health Services Administration, who’s here with me today.  We stole Pam from New Mexico where she led their human services department.  Some of you may know that she has more than 30 years of experience dealing with behavioral health issues in state government, city government, and as the CEO of non-profit behavioral health managed care firm.  She was just sworn in last week.  I don’t know if she’s had time to unpack yet.  But we’ve already had the chance to get together and talk about our plans for the next few months, and I know she’s going to be a great leader for SAMHSA. 

One of the things Pam and I have talked about is the huge opportunity we have in the next couple of years to make some big improvements in the lives of Americans with mental illnesses and substance abuse disorders.  There are a lot of changes happening right now that could have a big impact on behavioral health: parity, health insurance reform, the growing popularity of integrated care models, an increased focus on prevention, huge gains in our understanding of the science behind mental illness and substance abuse.