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[OldPsychDoc]

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families-brace-for-mental-health-cuts-will-other-states-follow-wisconsin 🙁

 

[vistaril]

families-brace-for-mental-health-cuts-will-other-states-follow-wisconsin 🙁

well, state budgets are out of control.....and cuts are being made across the board. mental health funding is no different. As psychiatrists we are all bias and may believe are fundung is more worthy of other funding. But if you ask most voters and taxpayers out there(who are really all that matter), whether they would prefer to see state mental health care budgets cut or law enforcement services(just to pick one), they would go with mental health services.....

everything needs to be cut, including publically funded mental health.

 

[digitlnoize]

everything needs to be cut, including publically funded mental health.

For once, I agree with you...although I'd like to see the mental health budget preserved.

The solution to all this is to slash our insane federal defense budget by >50%, then use that money to fix our country, including health care (including mental health, SGR, etc), education, etc. Unfortunately, it'll never happen...which I blame both sides for. Everyone blames the GOP for being warmongers, but defense budgets aren't significantly lower during Democratic administrations either.

 

[surftheiop]

For once, I agree with you...although I'd like to see the mental health budget preserved.

The solution to all this is to slash our insane federal defense budget by >50%, then use that money to fix our country, including health care (including mental health, SGR, etc), education, etc. Unfortunately, it'll never happen...which I blame both sides for. Everyone blames the GOP for being warmongers, but defense budgets aren't significantly lower during Democratic administrations either.

Agreed, when we are spending 350 BILLION on 12 new submarines, makes you wonder if we could just get 10 instead and use the 60 billion saved to prevent cuts like the ones in OPD article from being made.

http://defensenewsstand.com/NewsSta...7-billion-to-acquire-operate/menu-id-720.html

Also to get an idea of how much we are outspending China on defense. (Not to mention the fact that UK/France/Germany would surely be on our side if China ever got too bold)

 

[vistaril]

Agreed, when we are spending 350 BILLION on 12 new submarines, makes you wonder if we could just get 10 instead and use the 60 billion saved to prevent cuts like the ones in OPD article from being made.

http://defensenewsstand.com/NewsSta...7-billion-to-acquire-operate/menu-id-720.html

Also to get an idea of how much we are outspending China on defense. (Not to mention the fact that UK/France/Germany would surely be on our side if China ever got too bold)

given the choice between spending money to defend our country and spending money on govt social services of dubious value, I'll pick the former everytime.....

 

[surftheiop]

given the choice between spending money to defend our country and spending money on govt social services of dubious value, I'll pick the former everytime.....

While I don't necessarily support ron paul (despite agreeing with a fair amount of his stances), I do very much respect the logical consistency he applies when considering finances.

"We cannot talk about fiscal responsibility while spending trillions on occupying and bullying the rest of the world. We cannot talk about the budget deficit and spiraling domestic spending without looking at the costs of maintaining an American empire of more than 700 military bases in more than 120 foreign countries. We cannot pat ourselves on the back for cutting a few thousand dollars from a nature preserve or an inner-city swimming pool at home while turning a blind eye to a Pentagon budget that nearly equals those of the rest of the world combined."


Also as RP points out, its not clear that all this spending is actually making us safer

"I believe very sincerely that the CIA is correct when they teach and talk about blowback. When we went into Iran in 1953 and installed the shah, yes, there was blowback. A reaction to that was the taking of our hostages and that persists. And if we ignore that, we ignore that at our own risk. If we think that we can do what we want around the world and not incite hatred, then we have a problem. They don't come here to attack us because we're rich and we're free. They come and they attack us because we're over there. I mean, what would we think if we were –if other foreign countries were doing that to us?"

 

[notdeadyet]

given the choice between spending money to defend our country and spending money on govt social services of dubious value, I'll pick the former everytime.....

If you don't see our military as consisting of a sizable portion of dubious value, you've definitely never served.

This logic is exactly why our defense budget is so poorly spent. By turning the military into a sacred cow, we remove all accountability for fiscal responsibility.

I prefer the idea of making cuts even across the board. If we talked about cutting 20% from the military, police and fire every time we lopped 20% off of community mental health and education, I'll bet you'd see some of this bipartisanship I keep hearing about.

 

[whopper]

The government is doing more than it ever has. To bring up something I saw from Ben Stein, whatever your political bent, you simply cannot have the gov paying for two wars (yeah I know we're pulling out of Iraq), and healthcare, while at the same time suffering from a floundering economy and expect to pay for it all.

No government has ever done something on this scope, and the way it's going it's unsustainable. Without fixing, we will be heading down the same road as Greece. Things that economists always say are worse for the economy such as increasing printed money, skyrocketing the deficit, etc, well that's going on and it seems the only side angry with it is the side with the minority. When they come to power, now they adopt the same dangerous practice and the other side now whines about it.

Now to add in a left-wing person, (Bill Maher), to bring up something he said, everything in the US happens in California first, and then the rest of the US 5-10 years later. If that's the case expect the US to force incredibly hurtful spending cuts or otherwise go bankrupt, of course he was saying this when Bush was President. Now that his guy is in office, his overspending rants have toned down.

 

[nitemagi]

The government is doing more than it ever has. To bring up something I saw from Ben Stein, whatever your political bent, you simply cannot have the gov paying for two wars (yeah I know we're pulling out of Iraq), and healthcare, while at the same time suffering from a floundering economy and expect to pay for it all.

No government has ever done something on this scope, and the way it's going it's unsustainable. Without fixing, we will be heading down the same road as Greece.

Now to add in a left-wing person, (Bill Maher), to bring up something he said, everything in the US happens in California first, and then the rest of the US 5-10 years later. If that's the case expect the US to force incredibly hurtful spending cuts or otherwise go bankrupt, of course he was saying this when Bush was President. Now that his guy is in office, his overspending rants have toned down.

Though in California we do have the Mental Health Services Act, which is a 1% income tax on millionaires and is a dedicated fund for mental health services in the state, independent of the other budget woes. At least for now.

 

[whopper]

Just wanted to add, I put my post up, spent some time with my daughter, then edited it without realizing you quoted it.

 

[OldPsychDoc]

given the choice between spending money to defend our country and spending money on govt social services of dubious value, I'll pick the former everytime.....

Given that you consider services like adolescent case management and basic access to medical and psychiatric care for persons with severe and persistent mental illness to be of "dubious value", (and that you seem to believel that most psychiatrists--yourself excluded, obviously-- are "subpar" 🙄) I am truly amazed that you chose this discipline...

Keep people covered and out of the hospital vs. >$1000/day in the hospital (or prison--again, another story...). Let's talk value, shall we? Or is a human being's value determined by what they can cash pay for your private services?

 

[whopper]

Those people defending our country are coming back with mental illness, lots of it.

I'll say this and try to leave it at that because I don't want to get too political. IMHO part of the problem is America has been thrust as the peacekeeper of the world, all at our expense, and in the age of terrorism, it has become terribly expensive to maintain this cost. The stability of Europe and Asia are for the most part from us paying for it while countries like Japan pay very small amounts for their defense. IMHO NATO should divvy up some financial responsibilities on countries we literally end up defending on our dime in a more equitable manner.

Another issue is I think we Americans expect too much. As a whole we're fat, we don't eat healthy, but we expect healthcare. In WWII, kids helped find tin cans to support the war effort so that tin could be turned into bullets. Families made their own gardens so industrial farming could support the war effort. We've lost that. We're at war now but few people appear to show that sense of nationalism. I don't mean nationalism like the group-think in WWII Germany, I'm talking doing something because it's good for us as a whole because we believe it'll help our community. If we had that, I do think people, as a whole, and in a real sense of patriotism would start eating healthier, taking care of themselves, recycling, contributing to charity groups that are actually making a real difference in society such as Big Brothers and Sisters, and from that the costs of so many things would go down. Instead we got a nation that equates Hummers and drum-beating with patriotism, ridicules the smart kids, and gives street-cred to the guy impregnating as many women as he can and wearing sneakers that light up when they touch the ground while not doing anything to support his children, and Michelle Obama trying to get us to eat healthier, is being equated mind-control.

Nixon wrote in Beyond Peace that with Cold War ending, people only ended up pledging themselves to a beneficial national mentality when they had an enemy. He wrote that if only we could do it because it was the right thing, we'd be able to accomplish anything, and when he wrote that book, the Cold War had ended and the question what would we do in peace? If only we could do the right thing without an enemy.

Hmm, maybe we need Adrian Veidt because terrorism isn't doing enough to unify us. If you don't know who he is, in a sci-fi graphic novel, he's a multibillionaire who tricked the world into believing it would be attacked by outer-space aliens using a hoax that cost him hundreds of millions of dollars, and then all of a sudden all the world's problems were solved in a matter of days because everyone realized the only way they were going to have a chance against them was to work together.

 

[digitlnoize]

given the choice between spending money to defend our country and spending money on govt social services of dubious value, I'll pick the former everytime.....

The money we're spending to "defend" our country isn't actually defending it. It's bankrupting us. If we brought all our troops home from around the world and actually engaged their time in defending our borders, I think ANYONE would be hard pressed to attack us successfully, in any way.

Instead, we waste billions more than every other country in the world, and more than most countries COMBINED (40% of the entire world's military spending is the US) pissing everyone off and making more enemies (or as you and Ron point out: "blowback").

I would definitely prefer we spend that money on mental health. Education would be nice too. We're trying to defend our country on the outside, while it rots from within.

 

[billypilgrim37]

...I am truly amazed that you chose this discipline...

The "ignore" function works well, but y'all keep quoting vistaril, so I still have to read his screed and drivel!

 

[vistaril]

Given that you consider services like adolescent case management and basic access to medical and psychiatric care for persons with severe and persistent mental illness to be of "dubious value", (and that you seem to believel that most psychiatrists--yourself excluded, obviously-- are "subpar" 🙄) I am truly amazed that you chose this discipline...

Keep people covered and out of the hospital vs. >$1000/day in the hospital (or prison--again, another story...). Let's talk value, shall we? Or is a human being's value determined by what they can cash pay for your private services?

that's the worst argument liberals ever make- that if we don't pour massive amounts of someone elses money into their favorite programs, then the costs in the end will be even greater.....it never works that way.


your people with "severe and persistent mental illness" argument is lame.....most all these people are already on ssi disability, and if they aren't it's a massive failure of the same system(community mental health and other grant funded local resources) that you guys praise.....I know some of these medicare/aid populations still lose money depending on the services provided, but to act as if many of them have no access otherwise is untrue.....

regardless, it shouldn't be my problem. If you and other liberals feel so passionate about providing care to this population, do it with your own time(and thus money).....nothing is stopping you from doing that.

Im not against states spending hundreds of millions of dollars on mental health services any more than I am against states bloated defined contribution pension plans for example.......Im against both equally.

Also, the waste that goes on in some of these programs is massive. If they streamlined them and made them more efficient, that might at least make me appreciate them on that level. The quality of care they get, despite the massive dollars spent(on top of all the federal money that is spent on these pts) is just atrocious.......many of the state psychiatrists in my state can't speak english and I wouldnt let them change my oil, much less be my doctor....

sounds harsh, but we all know a lot of state hospitals are populated with that lack of quality......and I am aware there are some decent ones. But they don't represent the typical state psychiatrist....

 

[surftheiop]

that's the worst argument liberals ever make- that if we don't pour massive amounts of someone elses money into their favorite programs, then the costs in the end will be even greater.....it never works that way.


your people with "severe and persistent mental illness" argument is lame.....most all these people are already on ssi disability, and if they aren't it's a massive failure of the same system(community mental health and other grant funded local resources) that you guys praise.....I know some of these medicare/aid populations still lose money depending on the services provided, but to act as if many of them have no access otherwise is untrue.....

regardless, it shouldn't be my problem. If you and other liberals feel so passionate about providing care to this population, do it with your own time(and thus money).....nothing is stopping you from doing that.

Im not against states spending hundreds of millions of dollars on mental health services any more than I am against states bloated defined contribution pension plans for example.......Im against both equally.

Also, the waste that goes on in some of these programs is massive. If they streamlined them and made them more efficient, that might at least make me appreciate them on that level. The quality of care they get, despite the massive dollars spent(on top of all the federal money that is spent on these pts) is just atrocious.......many of the state psychiatrists in my state can't speak english and I wouldnt let them change my oil, much less be my doctor....

sounds harsh, but we all know a lot of state hospitals are populated with that lack of quality......and I am aware there are some decent ones. But they don't represent the typical state psychiatrist....

Most academic psychiatrists are "state psychiatrists" because the state universities they work for are the result of those pesky liberals wanting to educate people.
*Edit: I know thats not the typical meaning of state psychiatrist, but just pointing out that taxes do accomplish useful things like having universities and medschools

 

[DOC PENGUIN]

The money we're spending to "defend" our country isn't actually defending it. It's bankrupting us. If we brought all our troops home from around the world and actually engaged their time in defending our borders, I think ANYONE would be hard pressed to attack us successfully, in any way.

Instead, we waste billions more than every other country in the world, and more than most countries COMBINED (40% of the entire world's military spending is the US) pissing everyone off and making more enemies (or as you and Ron point out: "blowback").

I would definitely prefer we spend that money on mental health. Education would be nice too. We're trying to defend our country on the outside, while it rots from within.

Geez, where is Ron Paul supporting NeuroPsych doc need him, anyways if anybody could give me his name, that would be nice. Yes, Foreign policy spending is very very over funded, but is you look at the budget, you could cut the whole thing and it would still be unsustainable. I do think we need to adress the 3 big elephants. Social Security, Medicaid and medicare. I do think the latter ought to be left to the states and we should find a way to make SS sustainable. I think we can alleviate some of it but letting young people opt out. Still, if i had my way the New York State abandoned institution would be reopened.

 

[DOC PENGUIN]

The "ignore" function works well, but y'all keep quoting vistaril, so I still have to read his screed and drivel!

I guess we all have to read everybody's opinion, that what we are here for. And i learnt more about medicine and biology than my biology class in school. Still i do find it annoying that the overwhelming majority of Psychs are left of center. I guess Left of center people are more inclined to care. Lastly, how's fellowship, is it better than a regular residency? PS: please don't hate me.

 

[michaelrack]

given the choice between spending money to defend our country and spending money on govt social services of dubious value, I'll pick the former everytime.....

👍
Defense is the primary purpose of the federal gov. I can't buy my own nuclear bomb but I can buy my own health care.

 

[digitlnoize]

👍
Defense is the primary purpose of the federal gov. I can't buy my own nuclear bomb but I can buy my own health care.

I agree. The question is why are we spending many times more than everyone else to do it.

 

[vistaril]

I agree. The question is why are we spending many times more than everyone else to do it.

because without us they arent nearly that safe.......we provide part of europe's defense as well....dont think there is any question about that

 

[whopper]

Political debates can get very touchy feeling and range from flame wars to good intellectual discussions. Please let political debate be the latter. No name calling, no going in circles, yada yada yada.

Most academic psychiatrists are "state psychiatrists" because the state universities they work for are the result of those pesky liberals wanting to educate people.

Well in my university the default insurance is the state teacher's insurance that I opted out of into the private insurance, point being is that most university set-ups from what I understand do allow the doctors to be aligned in some respects to the state.

Still i do find it annoying that the overwhelming majority of Psychs are left of center.

Well I don't know if that's so much true as they are either liberal or libertarian and not social conservatives. Most psychiatrists I know for example aren't against homosexuality just because they don't think the government has a place condemning something that has to deal with someone's own personal life. Is that liberal or libertarian? Seems to me that could be both. Libertarianism can go across both the left and right. As for social conservatives, as patients, that's their choice too.

A good friend of mine, Don, that worked with me in the state hospital while I was there was a right-wing social conservative, and I'm talking strong right wing, but he still did his job well and stuck to professional guidelines. For example he didn't approve of homosexuality, but he never brought it up during treatment and provided homosexuals with the same level of professionalism that he did anyone else, and he'd be the first person to defend their right to good treatment if someone tried to stick their anti-homosexual beliefs upon a homosexual patient, but he'd also defend a right-wing patient too under the same guidelines if that person announced their beliefs and it was not to the liking of someone who disagreed with those politics.

We once had a patient labelled as hyper-religious and manic, and Don spent time with the guy, actually called up the local church where this guy worshiped, talked to the pastor there, and told me the guy was not hyper-religious, just highly Evangelical, and I had enough respect of Don's professionalism to be able to separate his religious beliefs from any possible mania. We also had patients who said they talked to God, but not in a psychotic sense, but more in a sense where they likened their conscience to being in touch with God. Don would've been the first to state that anyone calling such a patient psychotic was jumping the gun and he was right to do so.

 

[BobA]

👍
Defense is the primary purpose of the federal gov. I can't buy my own nuclear bomb but I can buy my own health care.

Why can't I buy my own nuclear bomb? Don't I have a right to bear arms?

 

[whopper]

I believe this was actually clarified in a law. Turns out the definition of arms only means firearms-like guns. I know this because some guy I used to debate often (on a different forum) that was a total GOP-nut (the guy was a Limbot. He'd say he was for something, then when almighty Rush told him to do the opposite, he'd play lemming and completely change course as if his prior rants never occurred despite that they were still in print on the forum) during a debate actually brought up the law and a link to it.

The right to bear arms protects the right to have guns, not a fighter jet, grenades, or a nuclear missile.

 

[billypilgrim37]

I believe this was actually clarified in a law. Turns out the definition of arms only means firearms-like guns.

I think this was part of DC vs Heller in 2008, which was actually the first court case ever to establish that the 2nd amendment actually protected an individual's right to have a firearm. Yes, in 2008. My wife ranted about this for awhile during her Con Law class.

 

[OldPsychDoc]

The right to bear arms protects the right to have guns, not a fighter jet, grenades, or a nuclear missile.

What about my broadsword and trebuchet?

 

[zenman]

What about my broadsword and trebuchet?

And my knives and throwing tomahawk....

 

[whopper]

A buddy of mine is a blacksmith and I play D&D with him. He gave me a huge broadsword he made for me a few weeks ago. Thing looks like it's from Conan's Cimmeria. I don't think though that I'd look good in a loincloth brandishing it around.

 

[surftheiop]

lol, seems every specialty has their weapons of choice, a lot of anethesia people seem obsessed with handguns and assault weapons. Apparently psychiatrists favor blades (wasnt there that story a while back of a psych getting attacked with his own samurai sword?)

 

[nitemagi]

lol, seems every specialty has their weapons of choice, a lot of anethesia people seem obsessed with handguns and assault weapons. Apparently psychiatrists favor blades (wasnt there that story a while back of a psych getting attacked with his own samurai sword?)

I would favor the melee just in preparation for the zombie attacks...damn bath salts.
However others favor alternative weapons...

 

[whopper]

Hmm well almost all the forensic psychiatrists I know have guns. I don't know if it's coincidence or an indication of the demographic.

I haven't bought a gun---yet. I keep thinking I'll do it then it's months later and I think the same thing, "I'll get one sometime in the next few months."