Market Forces and Mental Health Changes In The 1960s – How’s that Working for Ya?

In most instances, cutting deficits at the Federal level will mean a shift of costs to state and then to local county and city governments.  So called “market-based” solutions don’t work for many public services.

Take mental healthcare for instance.  Hospitals dedicated to treatment of the mentally ill fell into into disfavor in the 1950s about the time promising new drugs became available (click on the image below to see the change between 1950 and 1994.)

We jettisoned almost the entire system of care putting our faith in claims that things just weren’t sustainable, cutting government spending and shifting care to out-patient facilities like community mental health centers (which we never adequately funded as promised) while putting far too much faith in “market forces.”

Sound familiar?  With all due respect to the people who work so hard to serve the mentally ill, it has been a disaster, masked only when the passage of Medicare and Medicaid came to rescue.

All we really did, for all of our good intentions and obsessive cost-cutting, was shift the costs of caring for the mentally ill. And as a result, bankrupting families, flooding nursing homes and jails, populating the streets with panhandlers and the homeless, providing victims for criminals, turning police officers into mental care givers, making healthcare insurance unaffordable and….well it’s a mess.

You’ll forgive me then for being a bit skeptical about some proposals for overhauling Medicare and Medicaid in favor of “market forces.”  Click here to see one of many books on the topic, check out chapter IV.

Do I have the solution?  No, that’s beyond my pay grade.  But I can tell you this is an example of the “false” economies that come from those obsessed with cutting government while not raising tax revenues.

We’ve repeated a lot of history recently, allowing ourselves to be pull into not one but two wars reminiscent of the mistakes of Vietnam, wiping away critical regulations only to come close to repeating the Great Depression, crushing public sector unions and then wondering why we’ve got overly tired air traffic controllers?

It is imperative that we remember and avoid repeating what one conservative columnist calls “stupid cuts” and with the warning that “they’re liberals but they’re not idiots” to which I add that many more of us are Independents but we’re not idiots either.