"There comes a time when neutrality and laying low become dishonorable. If you're not in revolt, you're in cahoots. When this period and your name are mentioned, decades hence, your grandkids will look away in shame."
--David Brooks, New York Times
Of course, Mr. Brooks was talking about this election. But that point can be made in any year, or month, or hour, election or no election.
Those of us who know folks with certain mental illnesses--and who doesn't?--certainly don't want our friends going without the care they need. And deserve. As Americans, we spend quite a lot on health care, thank you, and a goodly portion should go to helping those with mental illness. It's as real a disease as any other. And, thank God, treatable.
But we have a hard time believing this latest cap on group therapy sessions is the end of such services in Arkansas. If we're going to have this discussion, please, less hyperbole. Please, more common sense. Come, let us reason together.
According to the papers, there are about 10,000 folks in Arkansas who go to group-therapy sessions through a Medicaid program. The state has just limited the number of one-hour sessions to 25 a year per person. That's an hour every two weeks. And you'd think the state had decided to cut off meds.
Not only are some in the industry, and we mean industry, saying it will disrupt patient care, but whole facilities are going to close! But not jails. What space still available in our always-overflowing jails will be filled with folks who needed another group therapy session.
All of that is hard to believe, given:
This state's Medicaid Inspector General, one Elizabeth Smith, says a report shows that Arkansas spent $147 million from 2013 to 2015 on group psychotherapy. Which was six times what Alabama, Georgia, Louisiana, Mississippi, Tennessee and West Virginia spent--combined.
Six times what six other Southern states spent, when you combine all six.
Elizabeth Smith says a cap would save the state money and improve care by discouraging excessive use or billing. And it's not hard to believe her.
As things stood, this state had no limit whatsoever on the number of sessions it paid for, and each daily session could go on for 90 minutes. Taxpayers could have saved $31.5 million between 2013-15 if it had just capped the sessions at an hour. And could have saved more than double that by limiting the sessions to 25 a year.
The papers also said that Arkansas reimburses well, to the tune of $55.20 a hour for these sessions. Which was higher than other states.
We wouldn't consider being smart with taxpayer money laying low or being neutral when it comes to treating mental illness in Arkansas. And, no, we don't think we'll be shamed in the eyes of generations to come if we don't spend six times what six states combined spend. When we look to Louisiana and Mississippi, we don't exactly see models of government efficiency. Why is Arkansas spending so much?
Maybe because there have been no limits at all. And when you combine "no limits" and "government" and "health care," things can get out of hand pretty fast. And seem to have.
Six times what six other Southern states spend. Combined.
Now that's crazy talk.
Editorial on 10/04/2016