Our Health Policy Matters

I started writing Our Health Policy Matters three and a half years ago, right after the 2010 mid-term elections. Since then, I have written about two policy areas about which I am passionate – public health and mental health.  As I explain below, I am about to change my professional focus.  And while I will be speaking about one more than the other in the future, for me these two areas are related. Let me explain why. Mental health and public health are first and foremost about wellness.  They are about identifying risk factors for disease and eliminating or mitigating them. Many of the same environmental risk factors contribute to poor health, especially poor mental health.  These include poverty, violence, abuse, and neglect.  When we address or mitigate these risk factors, we improve our nation’s health and mental health together. We often place the burden of responsibility for maintaining one’s health squarely on the shoulders of individuals.  But this is a too

A different kind of climate change was in the news this week, as Gallup reported that the percentage of people who are uninsured declined rapidly from 17.1 percent to 15.9 percent in just three months. That is a pretty substantial drop, and one that began when people started signing up for Obamacare. According to Gallup and others, it translates into an additional 3 million people who now have health insurance, consistent with the numbers of people signing up for Affordable Care Act coverage. That’s good news for Obamacare – perhaps.  One of the more interesting – and sometimes frustrating – things about health policy is that like climate change it unfolds slowly over time, and so it is often difficult to see the change in climate while it is happening. For one thing, there are always other variables.  For example, the unemployment rate has also gone down during this period, from 7.2 percent last October to 6.7 percent today . It is possible that some of these 3

It sometimes seems like policymakers go out of their way these days to pick on people with mental illness. According to a report released last week by the American Mental Health Counselors Association , 3.7 million people with mental illness will remain uninsured because of the decisions of states not to expand Medicaid.  And if you believe some earlier data from the Kaiser Family Foundation  about the total number of people who will be left uninsured because of states' failures to expand Medicaid, then you can only conclude people with mental illnesses account for nearly 80 percent of all those who are being denied insurance coverage in non-expanding states. This includes 652,000 in Texas and 535,000 in Florida, and around 200,000 each in Pennsylvania, Indiana, Georgia, North Carolina, South Carolina, Tennessee, and Louisiana. The association characterizes this as “dashed hopes” and “broken promises.” You might also call it a national disgrace. For thos