First, money. Max Baucus sounded level headed after eventually conceding to sit with inpatient and outpatient, mental health and med-surg providers who lobbied (without huge sums of money) and were recognized as a result of timely media coverage: in fact, all parties sounded level headed. Why weren't the providers given a sooner opportunity to speak? Why is Senator Baucus, the major recipient of insurance and pharma monies sitting as chair on that committee? Despite his experience and knowledge, why is he allowed to continue to sit on this committee?

Second, States' Rights. Specifically, the Seniors Mental Health Act of 2009 (S.671) now proposes that 2 new (state licensed, private practice) provider positions would become eligible for Medicare reimbursement — despite the fact that (as I understand it) some states do not recognize/license those specific positions. Broader language, allowing “all mental health providers AND alcohol and substance abuse counselors licensed for private practice by their respective states to become eligible for Medicare reimbursement”, allows each respective state to continue to determine who will practice within their jurisdiction and (the important change) receive concurrent Medicare reimbursement for respective services delivered to the elderly, those with chronic issues, and those with debilitating substance abuse struggles. I believe that: 1) the states can handle that responsibility and 2) the state populus is able to direct the respective state decisions. As I understand it, this change would not adversely impact the Medicare budget and, in some cases, would actually reduce Medicare expenditures by allowing Medicare to pay the provider directly, as opposed to paying the “signaturing” MD rate.

In appreciation for the work of the “committee of six” – here's to transparency.