Our Health Policy Matters

Back in 1980, Republicans nominated a television star with a limited understanding of federal government, zero foreign policy experience, and a platform of platitudes about reigning in a big government run amok. Image copyright unclear (on multiple websites); His main populist appeal was to middle class moderates and conservatives who were struggling both to keep their heads above water in a frightening economy and to understand the enormous changes that had democratized (and integrated) our society during the late 1960s and early 1970s.   To reassure us he led with this – a new theory of “trickle down” economics.  It held that if the government made the rich richer through historic tax cuts for the wealthy, they would re-invest those dollars in jobs for everyone else, and we would all become wealthier for generations to come. That didn't happen, but Ronald Reagan promised a new approach to governing, and a new way of life for the American people. Today, ...

Back in 1980, Republicans nominated a television star with a limited understanding of federal government, zero foreign policy experience, and a platform of platitudes about reigning in a big government run amok. Image copyright unclear (on multiple websites); His main populist appeal was to middle class moderates and conservatives who were struggling both to keep their heads above water in a frightening economy and to understand the enormous changes that had democratized (and integrated) our society during the late 1960s and early 1970s.   To reassure us he led with this – a new theory of “trickle down” economics.  It held that if the government made the rich richer through historic tax cuts for the wealthy, they would re-invest those dollars in jobs for everyone else, and we would all become wealthier for generations to come. That didn't happen, but Ronald Reagan promised a new approach to governing, and a new way of life for the American people. Today, ...

This might just be the year for mental health reform in Congress. A few months ago, practically no one would have said that. But on Wednesday of this week, the House Energy and Commerce Committee voted 53-0 to send H.R. 2646 - a significant mental health reform bill - on its way, most likely to the House floor for a July vote.  And in recent weeks, a Senate bill has gathered steam, too, and that chamber could also now take up this legislation this summer. So what happened to make mental health reform a real possibility? First, members of Congress sincerely wanted to do something.  The House proposal, sponsored by Rep. Tim Murphy of Pennsylvania and Rep. Eddie Bernice Johnson of Texas, has 199 co-sponsors as of today.  Our mental health system has been in disarray since - well, since as long as anyone can remember. Second, members have finally decoupled mental health reform from gun control.  Mental illnesses and violence have never been stron...

This might just be the year for mental health reform in Congress. A few months ago, practically no one would have said that. But on Wednesday of this week, the House Energy and Commerce Committee voted 53-0 to send H.R. 2646 - a significant mental health reform bill - on its way, most likely to the House floor for a July vote.  And in recent weeks, a Senate bill has gathered steam, too, and that chamber could also now take up this legislation this summer. So what happened to make mental health reform a real possibility? First, members of Congress sincerely wanted to do something.  The House proposal, sponsored by Rep. Tim Murphy of Pennsylvania and Rep. Eddie Bernice Johnson of Texas, has 199 co-sponsors as of today.  Our mental health system has been in disarray since - well, since as long as anyone can remember. Second, members have finally decoupled mental health reform from gun control.  Mental illnesses and violence have never been stron...

One of the most controversial elements of bipartisan mental health reform bills in Congress is a surprising one. It’s an effort to amend a 45 year-old regulation that outlived its useful life twenty-five years ago when the Americans with Disabilities Act (ADA) was signed into law.  It is referred to in Washington as “42 CFR Part 2.”  You might know it as the rule that forces you to sign at least two authorizations, instead of one, just to get your own health records sent from one place to another. Today, if you sign an authorization stating “please share all of my health records and medical history with another provider,” you might think that second provider is going to get everything.  But 42 CFR says substance use disorder isn’t covered by that – for that, you need a second one. Keep in mind that in 1970, when 42 CFR was being considered, you could discriminate against someone with a substance use disorder.  You could even fire them from their job....

One of the most controversial elements of bipartisan mental health reform bills in Congress is a surprising one. It’s an effort to amend a 45 year-old regulation that outlived its useful life twenty-five years ago when the Americans with Disabilities Act (ADA) was signed into law.  It is referred to in Washington as “42 CFR Part 2.”  You might know it as the rule that forces you to sign at least two authorizations, instead of one, just to get your own health records sent from one place to another. Today, if you sign an authorization stating “please share all of my health records and medical history with another provider,” you might think that second provider is going to get everything.  But 42 CFR says substance use disorder isn’t covered by that – for that, you need a second one. Keep in mind that in 1970, when 42 CFR was being considered, you could discriminate against someone with a substance use disorder.  You could even fire them from their job....

For the past several months, I've been traveling around the country for Mental Health America. I have been delivering two messages.  The first is that it was a mistake to use a "danger to self or others" standard as a trigger to treatment for people with serious mental illnesses.  Because this has made mental illnesses the only chronic diseases we wait until Stage 4 to treat, and then often only through incarceration. The second is that if we are to treat people with mental illnesses the same way we treat people with other chronic conditions, we have to act before Stage 4.  We have to start with prevention and then invest in early identification and intervention.  We have to integrate health, behavioral health, and other services.  And we have to give people an opportunity to recover at all stages in the disease process. May is  Mental Health Month . Since 1949, it has been a signature program of Mental Health America, formerly known as the Nat...