May 30, 2007

Obama Makes A Crazy, Brilliant And Disappointing Proposal

If you caught the news yesterday, you saw or read that Sen. Barak Obama (D-Ill.), campaigning for the Democrat presidential nomination in Iowa, proposed a new health insurance system for America, one that would cover the 45 million or so uninsured Americans, lower co-payments and so on. Good luck on that, Barak.

Far more interesting was the proposal he made on Memorial Day in New Hampshire. Here's a snip from a campaign press release:

"There are now more than 631,000 veterans of Iraq and Afghanistan, nearly a third of whom—more than 205,000—demonstrate symptoms of psychological or neurological injury. At the same time, the number of active duty military clinical psychologists has shrunk by 22 percent, and reports are surfacing that some veterans seeking treatment for PTSD are denied proper care and benefits on the grounds that they suffer from “preexisting” mental conditions.

"To address this growing mental health crisis, Senator Obama proposed critical enhancements at every stage of military service: recruitment, deployment, and reentry into civilian life."

I admire Obama--whom I don't have strong feelings for otherwise (it's early yet)--for taking up the flag on how badly soldiers are being wounded psychologically in Iraq and Afghanistan and looking to do something to address the military's culture of suck-it-up-soldier, which isn't particularly helpful to anyone who's seen combat in the urban guerilla mess we've gotten ourselves into in Iraq. I also admire his guts for saying words like "psychological injury" before a group of veterans on Memorial Day. Saying, in essence, that war breaks the minds and souls of big, tough soldiers and that we've got to be serious and thorough in our response or we're disrespecting their sacrifices as a nation isn't exactly going to get you on A-1 of too many papers, so I admire his candor all the more.

Many of the older vets in the crowd likely had a good idea of how such injuries play out across a veteran's life. I've seen this sort of thing first hand in my own life--in disabled vets I have interviewed over the years and in my own father, who I know was troubled for a time with bad memories of his own experiences in the Korean Conflict where, among other things, he flew ground support missions in the days when ground support was done more with machine guns and Napalm than with precision-guided munitions.

I'm glad someone in national politics is willing to put an issue like this front and center before another generation of young men (and women this time out) has no way to address the voodoo that's played out in front of them and said voodoo's aftereffects. A veteran I once interviewed who'd turned to drugs post-Vietnam told me, as I loosely remember: I killed the enemy and the innocent. It's what I had to do. I saw buddies killed right in front of me. When I came home I had all this hollowness in me that I couldn't find a cure for, so of course I took up smoking crack. (It was one of those rare moments when you almost stop taking notes because what is coming out of another human's mouth is so amazing.)

But I'm still disappointed in the Senator.

Obama's proposal operates on the assumption that we have a mental health treatment paradigm in this country that is working well and that troops can benefit from it. What we have is a mental health treatment paradigm that works poorly for civilian and veteran alike. Anti-depressants that work 30 percent of the time, anti-psychotics that barely quell the symptoms of schizophrenia and trash the human being in the process while pharma companies and researchers rush around proclaiming these treatments so useful for adults that they have got to be perfect for misbehaving children as well. Doctors who are little more than pimps for pharma companies. Taxpayers who are footing the bill. And so on.

When I hear Obama talk realistically about how crappy the current paradigm is for all parties and how, maybe, we need to be pursuing other approaches to America's weird age of psychological illness--because we are all mentally ill now, aren't we?--then I'll be truly impressed. Obama is promising the nation a "new politics," which sounds suspiciously like Bill Clinton's political sloganeering "Third Way." So when Obama--or someone else with guts--wants to acknowledge just how bad things are for everyone and how rotten many of the principal actors are in America's mental health paradigm, then I'll vote for him. But I'm not holding my breath.

Cynical side note: Obama's campaign has already received donations from people working for pharma companies albeit small ones to date. Go here if you are interested in such things.

Posted by Philip Dawdy at May 30, 2007 12:03 AM
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Comments

I believe his wife is or was a pushy hospital administrator. I give him credit for speaking on a topic that is so "bottom shelf" and so full of stigma.....

Big pharma is everywhere. They are like the mob in old NY.

Posted by: Angie at May 30, 2007 04:00 AM

"Obama's proposal operates on the assumption that we have a mental health treatment paradigm in this country that is working well and that troops can benefit from it"

That's a great point, and he as well as anyone else trying to reform health care has lots of time to be educated on the topic, eh?

I find the contribution list fascinating, and I see Abbott and AstraZeneca as well as Starbucks have bases covered on that one.

Posted by: Stephany at May 30, 2007 04:50 AM

"Obama's proposal operates on the assumption that we have a mental health treatment paradigm in this country that is working well and that troops can benefit from it."

Sorry, Philip. I just don't see that. It sounds more like he wants to overhaul a system that's not working. To his defense, he only knows what he sees and what his advisers tell him. Not to sound callous about mental health, but I don't think meeting with NAMI is at the top of his agenda.

Posted by: Marissa Miller at May 30, 2007 10:29 AM

The key part here is we don't have a mental health system that works now. So anyone wanting to overhaul health care in the United States, not only has an enormous, and almost impossible task before them; but the person MUST understand the military troops cannot be helped any better than they are right now, because what we have for ALL Americans, is a system that is dysfunctional, and medications that do their job about 50% of the time. There is a new mental health paradigm that needs to be created, starting at ground level.

The care as out patients is missing too many components. Hospitals or home--there needs to be for everyone, including veterans, a place to go, that is a step out of hospitals and realistically--off of the streets.

Combat post traumatic stress disorder in my opinion, is one of the most dire needs we have in this country right now, and I feel any one who has spent time in the military should be offered a lifetime of FREE care, and I mean GOOD care. The waitlists alone keep veterans from receiving any care at all, often leaving families struggling to pay medical bills, and find their loved ones decent mental health care.

I hope Barack or any one else speaking about health care reform sits down with real people and takes a look at real life situations, off camera--and without kissing baby photo-ops.

We cannot move forward with change, until we go backwards and see what was not in place to begin with.

Just my .02 for the day.

Posted by: Stephany at May 30, 2007 04:13 PM

Geez, Louise. One would have thought that the Senator would have known that our mental health system remains in shambles. After all, President Bush provided the following reassurance when he introduced his New Freedom Commission on Mental Health in 2002, "Our country must make a commitment: Americans with mental illness deserve our understanding, and they deserve excellent care." http://www.whitehouse.gov/news/releases/2002/04/20020429-1.html


From the The Letter to the President which accompanied the Interim Report of the President's New Freedom Commission on Mental Health, "Our review for this interim report leads us to the united belief that America's mental health service delivery system is in shambles." http://www.mentalhealthcommission.gov/reports/interim_letter.htm

Posted by: Joe at May 31, 2007 08:44 AM

Reporting in from hearing Obama speak in Seattle. Nothing specific about mental health issues, veterans etc.just reforming health insurance, education, and of course he will end the war in Iraq "when I'm in office." It was the most un-inspiring event I've been to, and hey I was at the re-election rally for Nixon when I was 12. He appears to be open-minded, and sincere, but there wasn't a platform yet worth a nickel.

Posted by: Stephany at June 1, 2007 11:28 PM

"I hope Barack or any one else speaking about health care reform sits down with real people and takes a look at real life situations, off camera--and without kissing baby photo-ops."

Unlikely. He's too busy taking baby-kissing photo-ops. While the mental health issue is a concern to us, we're a small majority of Americans. Obama has bigger fish to fry.

"One would have thought that the Senator would have known that our mental health system remains in shambles."

Good point. This should be common knowledge, but it isn't. Obama is more concerned with pushing universal health care rather than revamping ill-working systems.

Posted by: Marissa Miller at June 4, 2007 11:29 AM

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