Because of declining incomes, APA members should not have to pay higher dues. That was one of several recommendations made by Assembly representatives last month in Washington, D.C., at their November meeting.

After a lengthy debate, the Assembly approved recommending that the moratorium on the dues scheduled to end in 1997 be extended through 1998 with "specific plans to manage expenses compatible with a reduced dues income."

The amended action paper presented to the Assembly, however, called for mandating rather than recommending the continuation of the moratorium and was amended on the floor after many concerns were expressed.

Richard Bridburg, M.D., a former Assembly speaker, said, "I am concerned about the lack of data regarding potential damage to the Association. We are asking [the Board] to hold the dues and at the same time to raise money, and it takes time to do that. I am concerned about how much things would be cut in the meantime."

Area 3 Deputy Representative Lawrence Kline, M.D., commented that such an action is premature because APA's Chief Operating Officer Robert Trachtenberg is reviewing the budget to find ways to reduce costs without affecting programs and will present his recommendations in May.

APA Treasurer Fred Gottlieb, M.D., spoke in favor of a recommendation. "I am persuaded that both the Board and Budget Committee will hear this message loudly and clearly. It would be more useful not to tie our hands with such a paper, but to call us to be more stringent and careful with the budget."

Ann Sullivan, M.D., an author of the action paper, which came from Area 2, responded, "This is a critical membership issue. The Assembly needs to take a very strong stand on this and not just make a recommendation that dues should be held.

"I believe that members' income is dropping, and we will lose more members because of this. We need to face some hard issues related to cost cutting because we cannot depend on dues income indefinitely to support our programs."

Sullivan's comments were greeted with a round of applause. Nonetheless, the Assembly voted to approve Bridburg's amendment. The Board will receive the action paper this month for its consideration.

In other actions, the Assembly narrowly defeated (73 to 68) a recommendation that APA support the principle of universal health care reform, which may include a single-payer system. The action paper was defeated despite an amendment on the floor to delete a reference to a single-payer system in favor of universal health care reform, which the authors accepted. The motion to amend followed a representative's comment that a single-payer system will not eliminate managed care. Other representatives suggested emphasizing universal access to health care.

The action paper submitted by Area 2 representatives notes, "In the United States, current efforts to reduce health costs have resulted in shifting expenses, limiting options, and giving incentives to deny services. A single-payer system can reduce costs through administrative savings, so that there will be less need to compromise quality care and choice of provider."

The action paper continues, "A universal single-payer system can advance APA's current health care reform principles" including uninterrupted insurance coverage and the freedom of patients to select their own physicians.

The Assembly in another action advanced the Electronic Communications Project by approving the Committee on Planning's recommendation that each district branch receive $3,000 to purchase a computer. A contingency fund will be available to assist district branches with special needs on a case-by-case basis.

(Psychiatric News, December 6, 1996)