Give 'em Medicaid

Amid all the outpouring of sentiment for and against the bailout of the automakers, was an excellent recommendation regarding the form of said bailout: “Give ‘em Medicaid.” Here's why:

• It would be relatively easy to implement. The basic eligibility standard for Medicaid is that you have to be desperately poor, but in 1999, Minnesota was one of a handful of states who extended Medicaid (called M.A. in MN) to the working poor, if they were disabled. This has worked great (so far) and was easy to do. The rules could easily be changed to allow states to offer Medicaid to anyone employed (a certain # of hrs/wk) by a distressed automaker.

• It wouldn’t cost anymore than other bailout strategies, and probably no more than the cost of not bailing out – people are likely to become poor soon enough if they lose their job.

• It would be a huge help to the automakers. Currently, the automakers spend more on healthcare than they do on steel. This is a major disadvantage in competing with foreign manufacturers, whose workers get free, government-paid health care.

• It would improve Medicaid. In many respects, Medicaid provides second-class health care – the UAW wouldn’t put up with this for long, and as tens of thousands of workers get added to the roles, health care providers who currently disdain Medicaid would want the business.

• Best of all, it would be a huge step toward universal care. Everyone knows that universal, single-payer, health care is the only solution to our health care crisis that makes any sense. But no one, perhaps not even Mr. Obama, seems to know how to get there from the mess we’re in. This would blaze a path, one industry at a time.

Piece of the Pie...getting smaller and smaller

English Professor and author Christopher Lane recently wrote an editorial for the Star Tribune about the process (flawed in his opinion) for revising the “Diagnostic and Statistical Manual of Mental Disorders.” This probably gathered less attention than recent laments about our collapsing economy, but the two topics are more closely related than one might think.

As Lane explains, the DSM sets the rules by which insurance companies deny or approve payment for the treatment of emerging “conditions” such as compulsive shopping and parental alienation. Lane disputes the idea that such behaviors should be treated as real mental illnesses, and I tend to agree with him. They may be real conditions but it is a mistake to lump them in with diseases like schizophrenia.

My fear is that with these emerging “conditions” being defined as mental illnesses, funding for serious and persistent mental illnesses like schizophrenia will be shifted away. Maybe that seems selfish or even paranoid, but I’ve seen it happen over and over.

My dream is to see people with serious mental illnesses, such as schizophrenia, get the care they need to recover. Because I’ve also seen people recover, become contributors rather than consumers, and live meaningful, productive lives..