In his recent guest column (Tuesday, Feb. 21) in the Sun-News, Charlie Alfero, CEO of Hidalgo Medical Services, wrote “Thirty years of swimming upstream in the torrent which is the U. S. health care system is exhausting.
Article Launched: 03/03/2008 12:00:00 AM MST
Mr. Alfero then explains that much of the inequality in health care is due to the efforts of “major business, including health insurance interests, trying to squash anything that might take away from their current more-than-healthy bottom lines.”
Regarding mental health care specifically, a commentary by Ann M. Callahan, in the October publication of SOCIAL WORK (p. 364), titled “Second Thoughts from the Front Lines,’ suggests a similar reality to that which Mr. Alfero writes about. Ms. Callahan writes “The demand for our services often outweighs availability, but we try to meet our clients’ needs by creatively making due with what we have. Despite our best efforts, I believe reliance on managed care has led to systemic barriers that harm mental health workers and the people we are trying to serve.” She ends her commentary by writing “. . . mental health workers have become enforcers of the managed care system rather than advocates for systemic change. We have successfully used our expertise to normalize the injustice of managed care and operationalize program dictates despite seeing the inhumanity of it all.” I am guilty.
Both Mr. Alfero and Ms. Callahan recognize the inequality and lack of humanity of our current health system, and how those who work in it have become “tired and numb,” and even its “enforcers.” They both make a compelling argument for major systemic change, particularly removing the managed care/insurance company component — which estimates
suggest takes one-third of each health care dollar to operate — so as to provide higher quality and more services. However, Mr. Alfero argues the “wealth and ferocity of the private market place interests,” meaning the health insurance interests and their friends in business, is too great to oppose, so he suggests including them in reform. Unfortunately, this probably means continuing to swim upstream.
Here is where I think we need to look at bigger questions/issues, such as, what would our society be like if many, many more people were both physically and mentally healthier? How much of our society’s potential for prosperity is being stifled by the often marginal quality of health care we currently are providing to those who are poorly insured, or not insured? Isn’t the ongoing American Experiment about figuring out how to allow all our citizens to grow and prosper?
We do need to be responsive to the needs of those in the health care insurance industry if we decide their businesses are not needed in the system. We need to learn from these folks about the day-to-day nuts and bolts of running a health care system, and many of them may become workers in the new health system. For those who do not continue in health care, we need to retrain them and meet their health care needs.
It is going to take nearly all of our people, swimming together down stream, to invigorate the democratic process to bring about significant health care system change, an effort that might be on the same scale as that which brought us out of the great depression, or that which our first citizens, and Founding Fathers, made to form this nation. I think the results will also be similar.
John Funk is a social worker who lives in Las Cruces.
Website: Original Article