The November 1 issue carried an article concerning the Blue Cross/Blue Shield award to a psychiatric group in Connecticut called PsychCare. This is an attempt by a group of psychiatrists to provide statewide managed mental health care. The article quoted Robert Schreter as saying, "This is brand new. This is the wave everyone predicted."

I would beg to differ with your coverage of this event. This is not brand new. This group of psychiatrists has essentially excluded psychiatrists from the delivery of psychotherapeutic services in Connecticut through its contract with the Blues of Connecticut. They have set rates so low in the name of profiteering that most psychiatrists won't participate in this program. Certainly the physicians stand to make a great deal of money rationalizing their exclusion of psychiatrists with the same old mantra that Dr. Eist refers to in his article in the same issue of Psychiatric News. Setting rates 20 percent to 30 percent below those of any other managed care company in the state guarantees a profit at the expense of patient care. The patients always remain the losers in these programs whether administered by psychiatrists or entrepreneurial companies. The amount of dollars available for patient care is reduced by Blue Cross/Blue Shield, which takes a "cut" delivering this contract to this group of psychiatrists, who then take their cut for capitating and managing the contract while excluding psychiatrists who have worked in the state with Blue Cross/Blue Shield patients by setting ridiculously low fees.

This is the worst psychiatrists taking advantage of other psychiatrists and patients to deprive the public of psychiatric care. This is not "new"; it just represents another twist in depriving the public of needed psychiatric services.

James C. Bozzuto, M.D.

Avon, Conn.

(Psychiatric News, January 3, 1997)