Psychiatr News August 4, 2006
Volume 41, Number 15, page 3
© 2006 American Psychiatric Association
Psychiatry, Advocacy, And the Federal Budget
Pedro Ruiz, M.D.
The federal budget is a blueprint for establishing the nation's priorities
in critical areas such as health care, education, transportation, commerce,
natural resources, and defense. Of particular interest to APA members are
those areas of the federal budget that affect how physicians practice
medicine, how they are reimbursed for their services, and what types of
professionals are allowed to provide health care.
Other key health-related issues decided at the federal level concern access
to medical care and whether insurers must cover mental health services at
parity with other services. In addition, the federal government controls much
of the basic medical research funding in the United States, as well as the
level of medical care available to people in the military. Decisions related
to all of these issues have a significant impact on our profession, the
medical field, and, above all, our patients.
Unfortunately, the decisions are made in a bitterly polarized
atmosphere—one in which the scarcity of financial resources to fund
priorities is an ever-present reality.
Given the atmosphere surrounding the budget process, it is therefore
crucial for psychiatrists and other physicians to advocate actively during
this important political process. It is evident that our efforts as advocates
are essential for the patients, the profession, and the field. APA members
should be very pleased with the Association's vibrant, well-planned,
grass-roots advocacy program.
We have plenty of reasons to be hopeful that lawmakers and policymakers are
hearing APA's important message. I realize that sometimes it is hard to see
how our individual advocacy efforts can have much of an impact on the massive
federal budget, but be assured that those efforts can and do make a
difference.
A concrete example will help illuminate the positive outcomes of our
advocacy efforts. Over the past several months, APA's grass-roots efforts have
resulted in two significant victories related to the federal budget process.
The first relates to the Senate's approval of the Specter-Harkin funding
amendment. The second pertains to successfully urging moderate Republican
House members to support additional funding for public health concerns in its
version of the budget for Fiscal 2007.
The Specter-Harkin amendment added $7 billion to the Senate's version of
the Budget Resolution for Fiscal 2007, of which more than $1 billion would be
designated to fund research at the National Institutes of Health. Initially,
prospects for successful passage looked dim but with the assistance of members
of APA's grass-roots advocacy network contacting their senators to encourage
support, the amendment was overwhelmingly approved.
The House budget was delayed for several weeks as House GOP leadership
lacked the votes necessary to pass its version of the House Budget Resolution
(H Con Res 376). APA worked successfully with many health advocacy
organizations to persuade moderate Republicans not to support the House budget
resolution, as it did not contain adequate funding for health and social
service programs. The personal advocacy of many APA members helped postpone a
vote that could have resulted in harmful cuts to health care programs. The
delay forced House leadership to increase funding for health and other
domestic programs.
In an election year such as this, it is especially important that members
of Congress hear the voices of individual constituents and what is important
to them. Your role as physicians and psychiatrist advocates is even more
important than usual in this critical period leading up to November, when
elections will be held for every seat in the House of Representatives and
one-third of those in the Senate. Your active participation in APA's
Grass-Roots Action Network can influence the shape of the federal budget and
the priorities Congress sets for health care policy.
APA's Department of Government Relations will continue to keep you informed
as the budget process evolves, including ways in which you can help the effort
to preserve critical health care funding. It is possible that the House will
not be able to pass its version of the Fiscal 2007 budget, thus making the
Senate Budget Resolution the prevailing guideline for domestic programs. This
usually indicates that funding bills will be combined into an
"omnibus" spending measure after Thanksgiving.
As physicians and as psychiatrists, we have a responsibility to speak up
for our patients and the future of biomedical research. As a country, we must
allocate our funds wisely or pay an even higher price in human suffering and
societal costs. These challenges are daunting. It will not be easy, but as
recent events have demonstrated, we can be successful. Please join me in these
critical advocacy efforts. Together we can achieve our objectives. 
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