Perspective from Lisa Salerno: Over the past few months there is one word that seems to be associated with healthcare reform: delay. Delayed employer mandate, delayed grandfathered plan, all in the interest of giving the healthcare ecosystem time to implement drastic changes to the way it does business. With these delays comes uncertainty and …

Over the past few months there is one word that seems to be associated with healthcare reform: delay. Delayed employer mandate, delayed grandfathered plan, all in the interest of giving the healthcare ecosystem time to implement drastic changes to the way it does business. With these delays comes uncertainty and added costs.

Now I understand that Washington, D.C. is not The West Wing, or the same city in which Dave or even Mr. Smith operate but there is something to be said for taking a “practical look” at government. Having worked on the policy, weighing the virtues of one approach vs. another, I have a deep, personal desire to ensure reform works. It was a compromise bill, neither liberals, Blue Dogs or conservatives got everything they wanted but it was a collaboration following hundreds of hearings, testimonies and briefings.

As Washington, D.C. and the rest of the nation is focused on implementing the provisions of the Affordable Care Act to improve our healthcare system for the future, it is important we don’t lose sight of the immediate challenges facing our communities.

What Does Our Health Care System Need?

News coverage has been laser-like focused on changing deadlines and the associated cost. But does that mean we are neglecting other issues? What are our immediate healthcare needs?

One need that spans all socio-economic levels is greater access to better mental health services. It is estimated one in four American adults suffer from a mental disorder in any given year. And in a fragmented, costly, inequitable system, there is much room for improvement.

Following the recent finalization of the 2008 Mental Health Parity and Addiction Equity Act rules in November 2013 and a dedication of $100 million to services, more than 60 million Americans now have better access to mental health care. But this is a drop in the bucket.

We hear prevention is the best medicine. What is being done for children with mental health conditions? Poor pay, fledgling bodies of research and a lack of infrastructure cause many children to fall through the cracks.

What Next?

What if we, as a society, decide that healthcare is not a commodity for the wealthy few but is a fundamental, human right? And gone are the days that mental health is different than physical health? What can we achieve then?

One place to start? Placing licensed mental health workers in schools. Not just high schools where many conditions begin to present but in elementary schools and middle schools. Give schools the resources they need to properly address their students’ needs. While some schools are lucky enough to have not only an embedded community health center but also a mental health center, access to care should not be left to luck or home address.

Ideals are awesome but without practical implications, they are not worth their hot air.

Where do you see the greatest need in our healthcare system? What do you suggest needs to change?