Tuesday, April 16, 2019

The Fringe Versus the Mainstream

This would be an evil and irresponsible tweet coming from a single trolling individual.  However, I understand that such things happen, and have also read individual Republicans and Libertarians writing such unfair things.  It has always been so, and I remember it from my youth.  I don't know it it's worse now, but it was present then.

But the tweet is from the NH Democratic Party. A major political party is allowing its signature to be used on this. Perhaps I am simply not recalling when NH Republicans as a whole, or some prominent Republican spokesperson made a similar claim about Maggie Hassan, Jeanne Shaheen, or John Lynch. I again note that the Democratic mainstream - and now even in NH, which has been blessedly above this most of my life - is using the same language and tactics as the right-wing fringe. Give me counterexamples if I am wrong.

Mental health care is very expensive. In hospital, round-the-clock 1:1 suicide watches are not uncommon, and are labor intensive. (Run the arithmetic for how many of even your lowest-paid employees it takes to accomplish this for a half-dozen people every day. Small state, this.  Ramp up if you live in a state with more people.) Out of hospital, outreach to people so that they remain out of hospital is expensive, even at a few hours a day per person. Psychiatrists don't come cheap, round-the-clock nursing doesn't come cheap. Private hospitals go $2800/day, ours is $1357, with sicker and more violent patients. Republicans don't admit this because they want to pretend it's all cheap. Democrats don't admit this because they don't know if it costs a lot but don't want to know - they just want to list what they think we should do and send the bill to the citizens.  In my case, please note, I am not merely some crank making accusations at how Democrats just want to fund everything.  I am talking about real people who I work with who refuse to even look at the simple arithmetic*, because they are sure there are lots of rich and corrupt people out there who just won't pay their fair share, and it would only be a little more for each of us. So the budget is pinched and the expensive hospital is full with a waiting list, but somehow that's not really what's happening. Republicans not caring if people die, die, die is what's really happening.

So of course the only possible explanation is that those evil Other People must be getting paid off, bribed.  Everything would be good in the garden if it weren't for those hoarders.

Ranting. Sorry.  The irony is that we work in a building that was built as state-of-the-art thirty years ago when Chris Sununu's father was governor and pushed for it - and when he got to DC in the Bush administration, pushed for "Decade of the Brain" research funding. He was in many ways an entitled and arrogant bastard, but no taint of corruption has stuck, and he was always willing to allocate money well-spent.

*Not that social workers would get it even if they did look.  "I'd pay another $20 a week for this to be a country that took care of its poor and disabled the way it should." (Exact quote in a group of eight young social workers at lunch.  General nodding.) Yes, but would you pay another $200/wk? $400, if you make just a little bit more and are one of the better-paid in the building?  Or $600 week, if you are one of the best paid in the building? Pony up.  Pay it forward now, thanks. Then we can talk.


james said...

Is the allergy to seeing limitations a faith that someone somewhere is hiding all the money we need for everything, or is it a faith that if we bring our 5 loaves and 2 fish to the state it will be multiplied?

Vicious slurs aren't new at all. I seem to remember things said about Nixon. We didn't have a TV at the time (my parents wanted us to read--I guess it worked), so I didn't see the Goldwater bomb commercial until a few years ago.

RichardJohnson said...

I worked about a year as an aide/mental health worker at a private psychiatric hospital. Back then, it cost about $100 a day. Which means that costs have gone up about 3 times that of inflation, if one assumes that the hospital I worked at now charges around the $2800/day you quote. At the time, I earned about 10% above minimum wage.

From my time working there, I drew come conclusions that also affected my political views. 1)Money to fund things is finite. Time and again, patients were discharged because insurance ran out. Though for some patients, the insurance was quite generous- usually state employees.
2) Funding a certain program is no guarantee that the program will perform as promised or as proposed. As many psychiatric issues are difficult to intractable, Canute commanding the tide to recede comes to mind. Sometimes psychiatric care works, sometimes it doesn't. That doesn't mean that psychiatric care should't be funded. It does meant that funding it will not necessarily produce the results it wants.

From my year working at a psychiatric hospital I developed a skeptical attitude towards pols and activists who shouted to the world that they had a social program that was SO GOOD. Just fund it. Like Head Start, which has not done what it initially proposed to do.

I didn't leave with a high opinion of the Freudian approach, which at the hospital was viewed as mostly ineffectual.

Sam L. said...

Nobody knows the total amount of money it takes to keep the place open, AND provide treatment. But it MUST be out there somewhere...

James: Ah, The DAISY commercial. Dems lied then, and still do.