We have commented upon the role of the psychiatrist as an individual and as a member of the helping professions in a changing society, with particular reference to his responsibilities in the development and use of health insurance plans. Current pre-payment programs were examined and observations made regarding some of their implications which touch upon varied aspects of psychiatry, service, training and research and which are to be considered in the further development and refinement of health insurance plans. While additional expansion of pre-payment coverages is now warranted, our present knowledge of the specific requirements of the psychiatrically ill remains limited. It is necessary that we proceed with caution avoiding over-extending ourselves in our increasing preoccupation with insurance matters, pending a greater amount of information referable to the nature and course of mental illnesses, treatment objectives and responses to therapeutic interventions. This will facilitate a more meaningful relationship with insurors and better serve the needs of the patient, psychiatric practice and the furtherance of the voluntary health insurance effort. It is of note that the questions arising because of the presence of insurance plans have had the positive effect of sharpening our recognition of avenues of investigation demanding our attention as we progress in psychiatry and psychiatric practice.Abstract Teaser