Are the mentally ill and the poor human sacrifices so that the rest of us do not have to wait in line to get an MRI? Even if you have good health insurance, is this system worth it financially?
There are many sources that will show that Americans pay about twice as much as Europeans for their health care. I would tell you that we pay three times as much for health care in this country due to hidden costs. Here is an example.
The US has the largest prison population in the world. In 2005 there were 7 million people with some sort of contact with the correctional establishment (probation, jail, prison, parole). We have 5% of the world’s population and 25% of the world’s incarcerated. There are 2.1 million people behind bars (in 2006). That is 1/140 citizens. The cost to house these prisoners is $62 billion/year. That is $62 billion we do not get to spend on roads, education, and health care. Now admittedly we need some people incarcerated, but the fewer people who are incarcerated at a cost of $29,524 per person per year, the more money can be spent on the things our society also needs.
As it turns out 30% of prison inmates have some sort of mental illness. For many of them that is the only reason that they are incarcerated. In the 1970’s mentally ill patients were housed in warehouse type settings similar to what was depicted in the Jack Nickelson movie "One Flew over the Coo Coo’s Nest". Granted this was a less than ideal setting for the mentally ill but what happened next was a disaster.
During the 70’s there was concern for the human rights of these patients. Some of them were kept without their consent. Unfortunately, many people who are mentally ill also suffer from agnosognosia, which means that they do not recognize their own illness and do not feel that they need therapy. For example, they may be paranoid and feel that the people treating them are actually from a foreign government who is trying to imprison them. If allowed to leave the care of the institution they will. If allowed to stop taking medication, they will.
The upshot of this is that when Ronald Reagan was Governor of California he suggested putting the mentally ill in half-way houses where they would have more freedom and better care. An excellent idea actually. Unfortunately, after the warehouses were closed down, the funding for the half-way houses was not forthcoming and they also closed down. There was a flood of mentally ill patients who entered our streets and became "lost". Today 1/3 of the homeless are mentally ill. This sequence of events was repeated nationwide. This was great for "cost containment" for health care but horrible for programs for the homeless, shelters, and prisons.
We now incarcerate 7 times the number of people that we did in the 1970’s. As soon as the warehousing of the mentally ill stopped, they started to be arrested in large numbers. They were picked up for vagrancy, disturbing the peace and other petty crimes. The police and prison system are ill equipped to handle such people as evidenced by the recent news expose about a young man dieing in prison due to lack of water or food because he was mentally ill.
http://www.aclu.org/...
http://www.wsws.org/...
In prison not only are the patient’s at risk of bodily harm, but little is done to treat their disease. These people are in great torment. What would you think if the US decided not to treat any one with a broken bone and just put them out on the street? These people would not be able to work and would be in great pain just as the mentally ill are now. People who are seriously mentally ill do not realize that the things they see are not real or that they are being offered assistance. The things they see and feel can be as devastating as being in a war situation. They need and deserve our help, not incarceration in a modern day Bedlam. Even when they are not abused in prison they often learn behaviors that make it harder to help them in the future; such as aggression, extreme submissiveness, distrust of authorities.
Patients who are appropriately treated improve their life 60-80% of the time. This means they are not homeless and may actually hold down a job. (Currently 40% of the seriously mentally ill are unemployed.) Additionally, it’s cheaper. The VA estimates that it pays $2520/yr per person for their seriously, mentally ill patients. (They do a lot of outpatient care.) The cost of inpatient mental health is about $6971-$11,681 per year. (Note these are estimates of cost not what hospitals charge the families of the mentally ill which is a significantly higher number.) This is at least a 40% savings; $7.4 billion/year over incarceration. This is without even considering the cost of the police arresting these people, the community problems homelessness causes or the fact that many potentially productive work hours are lost as these people go untreated. How about using that money to fund the health care of the working poor or the S-CHIP program?
Other countries that have universal health care give their populations mental health care as well. When the US health care system is compared to these institutions it is an unfair comparison because we are housing our mentally ill in our prison system not our health care system. Of course this costs all of us more money and the mentally ill some times pay with their lives. "Cost containment" from the health care point of view means that the cost is shifted to the tax payer instead of the health care industry—even if we all pay more and get less.
This situation is a national disgrace. Overall I believe the average American is a kind and caring person. It is not lack of caring that creates this situation—it is lack of knowledge and nonstop propaganda about universal health care. Nothing that the propaganda machine says about universal health care is true. If we are spending 3 times what other countries spend in health care we should have a system 3 times as good. We do not. We are 37th out of 191 countries for some really good reasons. Having a shorter line for some people for some services is not an equal trade off for not helping or protecting those who need it the most. In this next election cycle we must insist on fiscal and moral responsibility. We must tell our representative that human sacrifice to the God of Cost Containment is no longer acceptable.