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                  <text>July 24,

1991

Honorable Daniel Moynihan
U.S. Senate
Washington, D.C. 20510
Dear Senator Moynihan,
As a psychiatrist with more
experience, I am writing with regard

than 40 years of professional

to the progressive deterioration in
medical care in our nation.
effects of the Great Society legislation
been
have
not
on medical care
salutary, and the present considerations
RBRVS
HCFA
fee schedules for Medicare for psychiatry will make
of
by
matters considerably worse.
The

guidelines provide inadequate payment for
practitioners for all psychiatric services to the elderly. Because these
guidelines will become the standard for all insurers, the impact on
psychiatric care throughout the nation will be negative.
Psychiatrists have been among the less paid members of our
profession, and instead of improving the availability of psychiatric
treatment, the proposed regulations will make care even more limited
The proposed

than

it is.

Are you aware that various psychiatric treatments are not
available in our State for the patients of the Office of Mental Health?
For example, convulsive therapy is an effective and safe therapy (see
NIH Consensus Conference report, 1985) which is available only in
academic and private hospitals and the few academic affiliated hospitals
of OMH. Under the present regulations, this effective treatment will be
even less available.

urge you to vote to eliminate the 50% copayment for
psychiatric services, and to improve the proposed MFS for psychiatric
I

treatment.

Thank you

for your attention.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

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              <text>Correspondence to: Moynihan, Hon. Daniel</text>
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              <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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