Wednesday, January 11, 2012

Unlimited Demand Meets Limited Dollars

The problem with "free" anything, especially health care, is it isn't really free. Someone has to pay for the item or service.

Another issue is when things are free, such as an all-you-can-eat buffet, some will abuse the system.

Then there are folks who really do need help, financially and otherwise, but there just aren't enough dollars to provide the resources.

The Atlanta Journal Constitution had an eye-opening piece on the shortage of mental health resources.

Evette King recently sat in her south Atlanta home fretting about how she could avoid eviction without someone to watch, feed and bathe her severely autistic son so she can work and pay the bills.

Last spring, King’s 19-year-old son, Gerald Stephens, joined a growing number of Georgians with mental illness or developmental disabilities who have been discharged or are at risk of being cut off from a state program that has been a life line for thousands of elderly and disabled people for the past 15 years.

The program -- which provides housekeeping, transportation to adult day centers, care management and other services -- not only helps people avoid ending up in nursing homes but ultimately saves taxpayers money, advocates say. Caring for someone in the community costs thousands of dollars less each month than in a nursing home.

In 2007, however, a federal agency told the state it had to move the program known as SOURCE -- Service Options Using Resources in a Community Environment -- under a different umbrella. The new, more restrictive framework limited it to the elderly and physically disabled -- excluding some people who suffer from schizophrenia, Down syndrome, bipolar disorder, depression, and other mental and developmental disabilities.

Mental illness, severe retardation, autism and other psychiatric conditions can be impossible to deal with in anything other than an institutionalized setting. Yet over the last 30 years or so, states have closed down many of these facilities and turned many of the residents loose on the streets.

Many of them have become part of our booming homeless population. Others have ended up on welfare, living in subsidized housing, collecting food stamps and using Medicaid.

Seems all we have done is rearrange the deck chairs.

Initially the move to free residents from the asylums was part of a move by social workers to erase the "stigma" of institutionalization.

This begs the question, which is worse? Institutionalization or homelessness and welfare?

But now it goes beyond the "shame" of being segregated from society and has become a monetary issue.

The truth is, the government does not have enough money to fund unlimited health care (including mental health) for anyone that needs or wants it. The folks in DC believe Obamneycrap will save health care for all by lowering costs and forcing everyone to pay or play.

In the meanwhile they are forcing people like Evette King to make some tough decisions.

Without a caregiver to watch Gerald, who needs constant monitoring, King is only able to work a couple of days or so each week when her adult daughter can help out.

King, who also has an 11-year-old son, has scraped together enough money to keep the lights on so far, but it’s unclear how she’ll be able to keep paying rent. Gerald recently became eligible for a different Medicaid-funded program for the developmentally disabled, but thousands of people are on the waiting list, said Wells, who is working with the family

Which is more important?

Funding sidewalks to nowhere or addressing the needs of people who really need assistance?
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