Ivan Milller, a psychologist, has written a thoughtful piece on mental health reimbursement (http://www.ivanjmiller.com/disparity_article.html). He argues “that there are differences in the way insurance companies reimburse mental health care and physical health care, and that the differences cause difficulties accessing quality mental health services.”

One dubious argument is that “…facts indicate that the managed mental health care is a special market manipulation that artificially lowers reimbursement.” Miller points to the low reimbursement for non-medical providers of mental health services.

I would argue that the low reimbursement is not the result of special market manipulation, but rather is due to: 1) the oversupply of psychotherapists; and 2) the higher value put on biological interventions (the rapid advances in biological psychiatry have revolutionized mental health care in the last 40 years). Psychiatrists do very well financially as do nurse practitioners who can prescribe. Both professions are in short supply. In fact, private data suggests that the incomes of younger psychiatrist’s are increasing very rapidly as their treatment armamentarium expands to include such treatments as suboxone, TMS, etc.