Blog Credo

The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

H.L. Mencken

Saturday, July 11, 2015

What's Next?

The fight for health care has been going since the Roosevelt administration.  The Teddy Roosevelt administration.  And it's close to being won:

Twelve percent is still too high, but the trend line is encouraging.  And each percentage point is about 3 million people.  So, not nothing.  Costs are coming under control, health care inflation is slowing...pretty much everything universal health care advocates believed - simply by looking at the rest of the world - is coming to pass.

So what comes next?

First priority should be to revisit the public option.  ACA works, but it's a patchwork.  Ultimately, hopefully, it's a transition to single payer, and by creating a public option, we can begin the process of unifying health insurance under a single, governmental entity.

The second priority is probably both bigger and smaller.  America needs to rethink and retool its mental health establishment.  One of the tragedies of the Reagan Era was the decimation of mental health hospitals.  This - combined with social spending cuts - is what created the homeless problem in America.  While there are always people at the bottom of the economic ladder moving in and out of homelessness, the endemic shelter population is overwhelmingly populated with the mentally ill and the addicted.

As of now, because few insurers cover mental health and few providers accept what insurance is available, mental health care is similar to what health insurance used to be: something the well-off could afford and something the poor fell into.  Those with resources could afford good treatment from excellent professionals and those at the bottom fell into certain social services that had rudimentary mental health abilities.

Personally, I believe the world is crazy and we make it crazier every day.  The clock, for instance, is about 200 year old.  It's not something we evolved with, yet it dominates our day.  We evolved in small, kin-based groups, now we live in cities with thousands...millions of people.

We have become a world of stress and depression and self-medication.  Stress evolved to help you find resources so you wouldn't be eaten by a lion of to scramble up a cliff.  It's not supposed to be an everyday occurrence.  And yet it is, and we are made sick by it.

So simply expanding mental health coverage to the general population is the small part.  Changing our culture is going to take a lot more work.

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