Will Gouge the Well-Being of Mental Health Consumers, and Others
On December 20, 2006-- with the overwhelming help of a Republican Congress-- President George W. Bush signed into law H.R. 6111, the "Tax Relief and Health Care Act of 2006." In his remarks prior to making this bill law, the President touted the fact that tax cuts would supposedly help low- and middle-income people, and that "health savings accounts" would make for affordable health care. Medicare cuts, however, he said would be a distinctive feature of this bill, consistent with the conservative agenda of the presiding Senate and House-- if not the pragmatic operation of the federal judiciary. In other words, it seems to be the assumption of the eclipsing Regime that the American does well with healthcare savings as long as "work works," but the situation may become more iffy by far: 1. if and when you get sick enough to be disabled; 2. when you retire or-- as a disabled person-- merge with the Social Security Retirement crowd.
The cuts will be steep in Medicare: by the year 2015, the schedule is for out-payments in Medicare to be reduced by 40%, while estimated inflation of real medical costs will increase by 40%. It is also quite true that Medicaid-- for the truly indigent-- including the millions of "grannies" and "grandpaws" who worked at average-or-more income and used Medicare until the funds run out-- THEY DO RUN OUT IN TIME-- many of them in one of the three forms of nursing home (personal, intermediate, skilled)-- WILL BE FACED WITH CERTAIN, SURE UNDERTREATMENT-- AND BETIMES PREMATURE DEATH. Obviously, for the many who worked and "played by the rules," voted for Reagan, the Bushes-Two, and Mitch McConnell-- THERE WILL BE RUDE AWAKENINGS COMING, JUST "DOWN THE PIKE," IN JUST A FEW YEARS, WHEN RETIREMENT/SICKNESS OCCUR-- AS THEY WILL IN EITHER ORDER OF SEQUENCE.
This cluster of developments concerns not only the "have nots," but the "haves" with wits and compassion about them: the American Medical Association (AMA) for example-- never known or interpreted to be a bastion of liberalism (in the sense meant just across the 49th parallel, in Canada)-- is stridently trying to undo the effects of this most-unwise and most-insensitive legislation. In a recent piece on the Internet, for example, the AMA stated,
"It is critical that Congress take action this year to replace the cuts [those indicated above] with positive updates based on practice cost increases. In a recent AMA survey of 8,955 physicians, 60 percent reported that they would have to limit the number of new Medicare patients they treat due to next year's cut. The Medicare Advosory Committee has recommended that Congress increase payment by 1.7 percent in 2008 in line with the estimated cost increase."
The mentally ill certainly are affected by this. While only 2-4% of the total population is comprised of schizophrenics, schizo-affectives, bipolars, the organic-brain-syndrome patients, and -- we need to mention the so-called "retarded"-- the best research shows that these comprise about 17-19% of enrollees to Medicaid and at the same time constitute 8.53% of enrollees in Medicare. What is more, it may be anticipated that a large portion, the "brunt" even, of cheap-as-hell medicine will hit the population of mental health consumers even harder than the general population: the hullaballoo about "mental health parity" also implies that the federal goverment itself does not equitably distribute funds for psychiatric care-- despite plenty of pressure to apply parity in the private sector. We-- meaning "mental health consumers"-- do not have a particularly powerful lobby-- nor have we historically shown much real skill as a group-- despite some weaklings-being-covertly-led-by-stronglings-called-a-mental-health-self-advocacy-movement. No: while it is possible to get quasi-plastic surgery for one's tummy (the bariatric operation is a freebie in Medicare), the mental health consumer will do well to get a "script" for some expensive-as-hell atypical antipsychotic from a Nurse Practitioner (not a M.D. usually, these days) and out-the-door with you!!! More likely it is getting that the psychiatric patient will "fall between the cracks," die in the grass-unmown of some backlot or languish in the new "backwards"-- jails (which give some lip-service occasionally to treating the mentally ill who happen into their custody-- a complete return to the incarceration-of-psychotics which outraged Dorothy Dix and all.)
I have mentioned nursing homes: a large contingent of mental health consumers reside in nursing homes (PCHs)-- preponderately personal care homes. It has ALWAYS been true since the inception of publicly-funded nursing homes that if a mental health consumer is in a PCH-- she/he will have to be sick-sick-sick-sick-nigh-unto-death's-door-indeed to get "intermediate" or "skilled" care. One certainly should assume that this bias will persist-- and become even more blatant and raw as a result of what the Congress-- and President signed into law in 2006 (and before in the same penny-wise-pound-foolish mode.)
INDEED: the mental health consumer has much to dread, even to feel terror, for what conservative Washington has inflicted on Medicare and Medicaid. Whatever way we have voted in the past-- "fightin' for Flag and Country" or not-- even if we like mean and callous politicians who "kick them deadbeats in the pants"-- we need as a cohort now to heed the real wallet issues that affect us-- as they will soon affect all Americans directly-- that when the chips-are-down there will be no "safety net" or security-- but because of the Ancien Regime we shall only face "the skids."
This sounds partisan-Democrat: very well, when I see a Republican party that does not oppose every imaginable form of socially-enlightened legislation or program-- beginning in the dawn of my awareness with opposition (vigorous!) to the Social Security Act, and to Medicare, and to Medicaid, and to the Americans with Disabilities Act and to the Community Mental Health Centers Act of 1963-- and just as vigorously oppose and blacklist people who espouse such utilitarianism-- calling them "bleeding heart liberals" (meaning "Sacred Heart Democrats" etymologically-- the "Catholic Vote" of the mid-20th century)-- THEN PERHAPS I SHALL SAY THAT THERE ARE REPUBLICANS WHO IN FINE "ARE WORTH A DAMN." OTHERWISE: NO!!!
Think about this, Republicans, especially Republicans-who-are-affected-by-mental-illness-- consumers, families, professionals: just what and when will YOUR PARTY heed what the arch-conservative John Rockefeller uttered, "With the accumulation of wealth comes increasing (social) responsibility."
---Vernon Lynn Stephens, M.S.S.W.
D.S.M. IV-TR # 296.44
E-Mail: freethink@bellsouth.net
posted by Louisville Hermitage @ 9:46 PM
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