The Time to Move Is Now
Are you frustrated and a little scared wondering who is going to be paying your doctor and hospital bills this time next year? I am. And most people I talk to these days don't even want to think about it. That’s because they can’t see where Congress is headed with health care reform. The current bills are so full of unknown factors that no one can predict with any credibility the consequences of enacting any of the proposals.
Meanwhile, any pending legislation has the potential to make or break occupational therapy's vision of empowered practice by 2017. The seeds of both opportunity and setback are in the mix. Which ones will take root? And how much power do we have to influence that?
Right now, the big push simply is to get everyone insured without breaking the bank. While the plans are being laid, it’s time to make a move. OTs work in all kinds of settings with all kind of programs. If you are doing something unusual that is working well and saving money with good patient outcomes, meet with your representatives and senators to show them how it can help insure quality care. Occupational therapy can not only fit into, but lead, the future of preventive care in both physical and mental health, and OT operating in the community can reduce hospitalization.
Lawmakers have historically acted on perceptions of who are "good guys" and who are "bad guys" in the health care environment. The good guys save them money and make them look good at election time. The bad guys cost them money and put them at risk of public displeasure. A case in point: Large rehab companies in the 1990s manipulated reimbursement rules and regulations to their own ends. A government investigation into the actual costs of rehab led to a public outcry. The ensuing crackdown created policy changes that turned rehab into a financial liability and sparked a two-year recession in the industry. Many therapists, most of whom didn’t even know how much their employers were charging for their services, lost their jobs.
The end result was that lawmakers saw occupational therapy as too expensive. Some of them still have that taste in their mouths. And OT is expensive. That’s why we’re seeing paraprofessionals come out of schools with degrees in certain skill sets that OTs also have, but who charge far less for their services. In response, thoughtful leaders of the profession are pushing consultative practice, in which OTs train others to do parts of their work. These issues will be of paramount importance as OT moves ahead, no matter in what environment it finds itself. Let your lawmakers know that you share their concerns about cost, and how your program or approach to care can help them reach that goal and still provide quality care.