Does health care have value in today's marketplace? This question has a silly side to it; everyone knows the answer,so why ask it? Because policy makers and legislators are making decisions that impair our abilities to be effective in providing health care services. For example, policymakers and politicians claim that healthcare costs are so far out of reach that an estimated 42 million Americans will go without health insurance at some point during the next 12 months. They use figures like the following to support those claims:

• Health care costs are a barrier to care, and medical bills create a significant challenge for many families.
• Uninsured adults (18% of the public) report considerably greater problems accessing health care because of the costs than those with insurance.
• Prescription drugs play an important role in health maintenance and many report that they have to forego either the medication or some other bill at times ("Health Care," 2005).

This information is a double-edged sword. There are the parts that certain national leaders spin to make it look as if it is our fault that health care costs are rising. But Medicaid has been decreasing reimbursements over

the past 5 years, not increasing them. We are working more hours for less money. We are not raising our rates; the only people raising rates or cutting corners are the MCOs and HMOs. Their administrative fees are going up, and their fees to employers are increasing, forcing employers to cut the services they offer their employees.

If you are self-employed or are employed with a small company, you have probably noticed the great increase in group health insurance premiums. This may mean that companies are increasing premiums to keep their profit margins. ''The nation's health maintenance organizations reported a 21.2 percent higher profit during the first 6 months of 2005 than they did for the same period the year before. Newark, New Jersey-based Horizon Healthcare Services earned $137 million, up from $36.8 million. New York Ciry-based Oxford Health Insurance earned $98.1 million, up from $44.5 million. Detroit-based Blue Cross Blue Shield of Michigan earned $208.5 million, up from $163.4 million" ("HMOs Earn," 2006).

It seems that every time I read about health care in the media it's about the "costs" side of our business. All this "cost" talk is spin for the MCOs and HMOs who are investing billions for lobbyists to pressure the legislators to support their plans and causes. From this day forward let's start talking, first among ourselves and then with our representarives, about the values side of health care. We could begin with the value we place on the length and quality of life, on treating pain and healing the sick and injured, on improving the lives of patients, on reducing health risks, and on research to develop more effective and less expensive trearments. And is there a need for our services? The answer is a resounding yes. "More than 51 million Americans have a mental disorder in a single year" ("Mental Health Issues," n.d.). Family violence is increasing and more people need not only medical attention but anger managemenr therapy as well as family therapy. Many others suffer from chronic pain, which psychotherapy and hypnotherapy can help relieve. Play therapy, family therapy, and individual psychotherapy have proven cost-effective at keeping studenrs in school and have a positive effect on their academics. Suicide attempts related to depression, anxiety, stress, and mental illness are another costly problem that therapy can help alleviate. The total burden of suicidal attempts and trearments on the overall economy of the U.S. marketplace during the same year was estimated at $125.8 billion (Gallagher, 2002). Additionally, "Employee absenteeism due to depression cost U.S. businesses between $33 billion and $44 billion per year. Anxiety related disorders cost the U.S. $42 billion a year in work-related and medical losses" ("Mental Health Month," n.d.). Here, then, is a small picture of the value of adequate medical and mental health care. The real costs are not in the treatment of diseases and disorders, but in not treating them. These include indirect costs such as the loss of productiviy at work, loss of time at school, and premature death or disability. Perhaps health care providers should hire a public relations firm to guide us through the development of a strategy to educate the general public on what we can do if we are allowed to. If the general public ever gets the message of our potential worth to them fan their families, maybe Congress and state legislatures would be flooded with letters of support for our services. Educating the general public with strong creative messages about our value is certainly cheaper than crying to match the insurance companies lobbyist for lobbyist.

References

1. The anxious child. (2004, November). The Academy of Child and Adolescent Psychiatry. Retrieved May 8, 2006, from www.aacap.org/publications/factsfam/anxious.htm
2. Gallagher, K. (2002, February). Suicide in Colorado. Denver: The Colorado Trust. Retrieved may 8, 2006, from www.cdphe.state.co.us/pp/Suicide/SuicideReport.pdf.
3. Health care costs survey. (2005, August). USA Today/Kaiser Family Foundational/Harvard School of Public Health. Retrieved May 8, 2006, from http://www.kff.org/newsmedia/7371.cfm.
4. HMOs earn $7 billion in first half of 2005. (2006, January 30). Weiss Ratings Inc. Retrieved may 8, 2006, from http://www.weissratings.com/News/Ins_HMO/2006013hmo.htm.
5. Mental health issues and statistics. (n.d.) Mental Health Infosource. Retrieved May 8, 2006, from www.mhsource.com/resource/mh.html.
6. Mental health month 2004: General mental health facts and stats. (n.d.) National Mental Health Association. Retrieved May 8, 2006, from www.nmha.org/may/fastfacts.cfm.