Our Health Policy Matters

A column focusing on federal, state and local health policy                      

To Improve Health, Spend More on Social Services click headline to view blog post

Does a stronger safety net mean a healthier community? Apparently so, according to recent research...

Attached a link to a recent Miami Herald article entitled State Senate proposes $87 million cut in mental health, substance-abuse programs reporting that a Florida Senate proposal would make deep cuts in funding for adult mental health and substance-abuse programs, and entirely eliminate support for some of them. The proposal would slash overall state spending on adult mental health and substance-abuse treatment by about 40 percent, or $87 million. The cuts would include eliminating state support for some programs - including, potentially, the Miami Behavioral Health Center and the Northside Mental Health Center in Tampa.

Sen. Joe Negron, the Stuart Republican in charge of the Senate's healthcare budget, stated that "When it comes to funding, an 85-year-old woman in a nursing home matters more to me than a 45-year-old guy with a substance-abuse problem," he said. "It's all about priorities." Unfortunately, his statement reveals that most politicians have yet to understand that mental health and substance abuse treatment represents cost-effective care!

The benefits of treatment far outweigh the costs. Even beyond the enormous physical and psychological costs, treatment can save money by diminishing the huge financial consequences imposed on employers and taxpayers. Comparing the direct cost of treatment to monetary benefits to society determined that on average, costs were $1,583 compared to a benefit of $11,487 (a benefit-cost ratio of 7:1)! In comparing cost offsets in Washington State of people in treatment to non-treated, the authors noted lower medical costs ($311/month); lower state hospital expenses ($48/month); lower community psychiatric hospital costs ($16/month); reduced likelihood of arrest by 16%; and reduced likelihood of felony convictions by 34%! It is a penny wise and pound foolish approach to CUT finding for mental health and substance abuse treatment because, in the long run, we as tax payers have to pay the higher price for short term political decisions.

For more information see Cost Offset Substance Abuse. I urge you to e-mail, call or write Senator Negron!

Dr. Wollschlaeger is a frequent contributor to FHIweekly and Specialty Focus. You can read more of his articles by visiting http://floridadocs.blogspot.com/. 

I've written two blogs this week, both about mental health policy. My regular Our Health Policy Matters column entitled Mental Health Cuts Will Lead to Increased Health Costs speaks to the problems caused by continuing state cuts to mental health services.  The second was published by Health Affairs, and is entitled Challenging the Policy of Disdain for Chronically Homeless People.  You can link to either or both directly by clicking on the name.  I hope you find them useful!

Attached a link to an interesting article written by John Dorschner titled "Hospitals hiring doctors to get ready for reform" highlighting the growing trend of hospitals purchasing physicians practices. It is of interest to note that executives at Baptist and Holy Cross say "the physicians' practices on their own do not break even after being purchased, but ancillary income from such measures as diagnostic tests boost the bottom line."

But more diagnostic tests and procedures also mean more health care expenditures! At Jackson Health System, Miami-Dade's public hospitals, the unaudited financial statements for fiscal 2011 show that the doctors' practices lost $4.4 million!   One employed physician argues that he likes this arrangement because he doesn't have to spend time dealing with all the business aspects of a private practice. But understanding the business of medicine is exactly what we need to prevail in the rapidly changing health care environment.

We cannot pretend that we can practice medicine in splendid isolation and to leave the "dirty" business to others. That's a prescription for certain marginalization and disempowerment. We must acquire knowledge and skills to master the business of medicine in order to practice medicine more efficiently.
What do you think? 

Dr. Wollschlaeger is a frequent contributor to FHIweekly and Specialty Focus.  You can read more of his articles by visiting http://floridadocs.blogspot.com/.