Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy - NYTimes.com

So psychiatrist are unhappy because they choose to get paid more (for drug therapy) than do what they love (talk therapy)?  Am I missing anything?

The key challenge we face, and I'd argue the biggest reason people oppose Obamacare is actually an existential problem.  People don't like to be cogs in a machine and they are trying to deny government the ability to make them a cog.  But they misdiagnose the problem as they are raging against a machine which the government is trying to sign on to.  The insurance industry has already made people cogs and opposing the governments efforts to make health care accessible to millions who can't afford it or can only receive subpar insurance that will bankrupt them if they get truly sick isn't going to allow people to get back to the good old days when your family doctor made house calls and new the names of your sisters kids.

The most productive discussion about what we need to do in terms of reforming our health care system occurred after the discussion moved away from the existential frustration to a discussion that centered on the bells and whistles of what should be done---all you have to do is look at the way individual parts of the bill poll well. 

Doctors are also feeling a loss of intimacy.

Medicine is rapidly changing in the United States from a cottage industry to one dominated by large hospital groups and corporations, but the new efficiencies can be accompanied by a telling loss of intimacy between doctors and patients. And no specialty has suffered this loss more profoundly than psychiatry.

They are making a lifestyle choice.  The doctor that the story centers around, "like a good Volkswagen mechanic.”  A good Volkswagen mechanic that doesn't want to disclose how much he makes. Don't get me wrong, existential problems are important and shouldn't be disregarded in policy questions.  I would argue that having meaningful, fulfilling work, is important.  I just thought it a bit odd when the crux of the story really hinges on this:

When he started in psychiatry, Dr. Levin kept his own schedule in a spiral notebook and paid college students to spend four hours a month sending out bills. But in 1985, he started a series of jobs in hospitals and did not return to full-time private practice until 2000, when he and more than a dozen other psychiatrists with whom he had worked were shocked to learn that insurers would no longer pay what they had planned to charge for talk therapy.

“At first, all of us held steadfast, saying we spent years learning the craft of psychotherapy and weren’t relinquishing it because of parsimonious policies by managed care,” Dr. Levin said. “But one by one, we accepted that that craft was no longer economically viable. Most of us had kids in college. And to have your income reduced that dramatically was a shock to all of us. It took me at least five years to emotionally accept that I was never going back to doing what I did before and what I loved.”

He could have accepted less money and could have provided time to patients even when insurers did not pay, but, he said, “I want to retire with the lifestyle that my wife and I have been living for the last 40 years.”