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Mosher, P.W. (1999). Managed Care For The Perplexed. J. Amer. Psychoanal. Assn., 47(3):921-928.

(1999). Journal of the American Psychoanalytic Association, 47(3):921-928

Managed Care For The Perplexed

Paul W. Mosher

The Dictionary Of Managed Behavioral Health Care: “A” Is For “Access.” By Jodi Aronson. New York: Brunner/Mazel, 1997, 50 pp., $9.95 paperback.

The Managed Care Answer Book For Mental Health Professionals. By Gayle McCracken Tuttle and Dianne Rush Woods. New York: Brunner/Mazel, 1997, 152 pp., $21.95 paperback.

The Textbook Of Behavioral Managed Care: From Concept Through Management To Treatment. By William L. Poynter. New York: Brunner/Mazel, 1998, 137 pp., $37.95 hardcover.

Two years ago Harold Eist, then president of the American Psychiatric Association, called managed care a “tyranny” as he urged professionals to “rise up and wipe this scourge from the face of the earth” (Dixon 1998). Only one year later, Psychiatric News, the APA house organ, carried the front-page headline, “Managed Care Now ‘Firmly in Control’ But Its Shape Remains in Question.” Managed care is currently the predominant third-party funding mechanism for outpatient “psychotherapy” in the United States, where more than 85 percent of employer-based health insurance is now provided through HMOs or managed care plans.

A tidal wave of economic change has swept over the practice of out-patient psychotherapy in the United States in the past five to ten years. Although the restructuring of the American economy has been felt somewhat late in the health care sector, profound changes, having finally arrived, have left many professionals disoriented, confused, or in a state of denial as words lose their old meanings and, in the spirit of managed care's “resource-based cost-savings,” are recycled for new

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