Thursday, September 19, 2013

Crazy is as Crazy does

Another gunman has gone on a shooting rampage.  Everybody from politicians and opinion makers to John and Jane Public express outrage.  Partisans get behind their well-worn(out) talking points.  “See what happens when guns are so freely available.”  “Who needs this type of gun to hunt?”  “Background checks.”  “Violent videogames (tv shows, books, comic books, etc.) are the cause!”  “We need to deal with mental health.”  There’s actual merit in each point, but it’s crazy what America does with the least sane amongst us.

According to the National Institute of Mental Health, mental disorders are so common that approximately one quarter of adults are diagnosable for one or more disorders. The main burden of illness is concentrated among a much smaller proportion (about 6%) who suffer from a seriously debilitating mental illness.
I’m not a doctor, haven’t studied the nuances of psychiatry or psychology outside of my own personal issues and don't play one on TV.  Despite this limitation and with all of the political incorrectness I can muster:  anybody who takes a gun and goes to a public place and mows down innocent people is nuts.

It takes resources to tackle this issue.  According to NIMH in 2006 (the last year data is available) $57.5 billion was spent  which is 6.2% of all healthcare spending. 23% went to pharmaceutical costs, 22% to physicians and other professionals, and the remainder was split amongst various types of institutions, hospitals, administrative costs, etc.
On October 1, 2013 – days from this posting – the Affordable Care Act affectionately known as ObamaCare – will take effect.  (Well the parts that they haven’t postponed or exempted will kick in.)  This trillion dollar program isn’t the one-stop-shopping healthcare Armageddon that right-wing conservatives have been warning against and that many left-wing liberals wanted.  Instead it is an insurance company bonanza, with the Government mandating that individuals either buy a policy or penalties kick in – both at the individual and employer level.  The idea is that with more people insured, then there’s more money in the healthcare system to service everybody.  It’s about providing access to healthcare…not actual healthcare.  (Congress received an exemption from the Obama Administration so it won't have to apply the law to itself.)

The legislation compounds the biggest problem in healthcare:  insurance itself.  Anybody who’s had to navigate the system for themselves or a loved one knows that the costs and problems lie within the insurance system and its various rules and policies.  Those regulations have been imposed by various government agencies at the behest of insurance lobbyists. And the circle is therefore complete.

In theory it’s great to get more people access – but with deductibles, co-payments and other restrictions, how many people will get actual healthcare?

As a free market capitalist, I have to admire the insurance companies and how they’ve totally co-opted the healthcare industry.  When Richard Nixon began Federal regulation of the healthcare industry 40 years ago it was unimaginable that anybody other than doctors would be making medical decisions.  Today the first African American President’s signature legislative achievement is the one that further cements the insurance companies at the center of the healthcare system and doesn’t help out sick people.  As somebody who’s seen friends and family suffer (and die) because of these rules and regulations, I’m at complete odds with myself.
Health can’t be a commodity that is bought and sold.  The balance between capitalism and socialism in healthcare that existed for generations it out of whack.  It is time for the pendulum to swing.  American citizens (like every other first world country) must be able to walk into a medical facility and obtain treatment – whether it’s for a broken limb or a broken spirit – and not have the economic impact bankrupt them and their family.  Crazy thinking, right?!?

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