(November/December 1998)

The Ad Hoc Committee to Defend Health Care, made up of a number of health advocacy organizations, held a public hearing on Wednesday, October 21, to publicize the status of mental Health care in New York. The New York City Chapter of NASW is a member of the Committee and participated in the planning and presentation of the hearing, held at Hunter College School of Social Work.

Dr. Carmen Ortiz Hendricks, the chapter's past president was moderator of the hearing which attracted social workers as well as psychiatrists, nurses, psychologists, advocates and patients. They provided an alarming picture of neglect, lack of access, poor quality care and inappropriate care due to the emergence of managed behavioral health care and the withdrawal of support for mental health services needed by patients.

The New York Group of The Ad Hoc Committee is concerned with the adverse impact of for-profit, corporate health care on patients. The New York Group is tied to a growing movement across the United States seeking to end for-profit, corporate health and mental health care.

Gerald Beallor, Co-Chair of the Chapter's Health Care Policy and Practice Network, gave testimony on behalf of the Ad Hoc Committee. He directed his remarks to the question, "Why are we seeking to end for-profit, corporate mental health care?" He questioned:

"What are the characteristics of for-profit health care which are destructive to the provision of quality health care?"

• The first responsibility of a for-profit is to return a profit to its shareholders. Cost saving, has a higher priority than quality patient care.
• The patient consumer is transformed into a corporate asset, a commodity in the health care system. The huge profits and escalating stock values of recent years have resulted from health care systems buying or merging with others. Their value in the transaction is determined by their commodities, known as lives (as patients are known to managed care organizations).
• Because of the importance of maintaining a significant operational profit margin, treatment decisions have been influenced by cost.
• Using various types of gatekeepers, access to specialists, ancillary care and medications have been limited.
• These same gatekeepers are often instructed as to which care modalities may by utilized in the care of patients.
• The roles of professionals, including physicians, have been down-graded as clerical-administrative-accounting decisions have overridden professional judgement.
• Effective care and treatment cannot be optimal when the patient's family and social environment are not dealt with. Social workers have stressed "the person-in-environment" approach to health and mental health care, but are unable to apply this approach in the tightly managed care of the for-profit corporation.
• Confidentiality, an essential ingredient in the provider-patient relationship is not observed in many for-profit managed care situations. This is particularly true when the employer is the insurer and care data must be shared with that employing organization.

"We urge public officials and legislators to continue their efforts to enact regulations and legislation to restore balance."

Other social workers who gave testimony included: Rosalyn Gilbert, Alliance for Universal Access to Psychotherapy, Alicia Sainer, Beth Meehan, Alan Mackie and John Chiaramonte.

The hearing was attended by public officials including Councilwoman Una Clarke, Chair of the Subcommittee on Mental Health; a representative for Alexander "Pete" Grannis, Chair, Assembly Insurance Committee; Representative Carolyn Maloney; a representative for C. Virginia Fields, Manhattan Borough President; and Tom Hilliard for Public Advocate Mark Green.

The Ad Hoc Committee will sponsor another public hearing on health care and the uninsured in Queens in early December. For further information on these and other activities seeking to stop the growth of profit driven health and mental health care, contact NASW at 212-668-0050. Inquiries will be referred to the Health Care Policy and Practice Network which has joined with other groups in coalitions to seek universal access to health and mental health care.

Other social workers who gave testimony included: Rosalyn Gilbert, Alliance for Universal Access to Psychotherapy, Alicia Sainer, Beth Meehan, Alan Mackie and John Chiaramonte.

The hearing was attended by public officials including Councilwoman Una Clarke, Chair of the Subcommittee on Mental Health; a representative for Alexander "Pete" Grannis, Chair, Assembly Insurance Committee; Representative Carolyn Maloney; a representative for C. Virginia Fields, Manhattan Borough President; and Tom Hilliard for Public Advocate Mark Green. The Ad Hoc Committee will sponsor another public hearing on health care and the uninsured in Queens in early December. For further information on these and other activities seeking to stop the growth of profit driven health and mental health care, contact NASW at 212-668-0050. Inquiries will be referred to the Health Care Policy and Practice Network which has joined with other groups in coalitions to seek universal access to health and mental health care.