Life, Liberty, Happiness, and Managed Care

As for entitlement to life, obviously suicide, homicide, and inability to care for oneself are clear obstacles. We have anecdotal evidence that managed care has allowed some catastrophic outcomes to occur, although managed care emphasizes that medically necessary treatment definitely includes treatment to reduce suicidal and homicidal risk. As for the second right, liberty, it is clear that managed care is limiting choice and freedom about which clinicians patients can choose and about how clinicians will be paid to provide treatment. In the pursuit ofhappiness, appropriate mental health care may l)e even more important than health care. Even for a patient who has a life-threatening medical illness, a clear mind can permit attainment ofhappiness through a new perspective on the meaning and preciousnesss of the life remaining. And in more common circumstances, medication and psychotherapy can effectively alleviate depression, anxiety, obsessions, and other psychiatric symptoms that inevitably compromise the pursuit ofhappiness. Psychotherapy, in particular, can also help improve the personal insight that may be necessary to pursue happiness.