HOLIDAY WISH LIST
By Mickey Skidmore, ACSW
For nearly two years I have expressed my views about several aspects of healthcare delivery in this country – particularly as it relates to mental health issues. One need only review the previous twenty-one “Perspective” articles to ascertain the themes of my editorial prose. In keeping with the Holiday spirit, I have put together a “wish list” which reflects these themes, in hopes that some day, some of these wishes may come true.
Perhaps my deepest and most profound wish is for our people – from politicians and legislators at the national level, to the grass roots level of every community, to ensure that quality healthcare will become a fundamental American value. A basic human right of every American citizen as opposed to whether or not one can afford it. And equally important, to determine a fair and reasonable way to pay for it. Realizing what a major wish this is, perhaps a more realistic list might include:
*A national grass-roots movement demanding that our politicians and legislators put forth meaningful federal legislation holding Insurance & Managed Care Companies responsible and accountable for wrong-doing and harm which comes to consumers when they impose market and business practices to healthcare delivery.
*That this federal legislation include provision for severe financial penalties/fines to the companies for dictating treatment or otherwise extorting consumers or providers for offering treatment or services deemed appropriate by medical professionals.
*That this national grass-roots movement further insists that our politicians and legislators include in this legislation statutes which include behavioral and mental health and conditions on equal footing with other healthcare coverage.
*That healthcare services would once again be developed around the most appropriate needs of the patient rather than what managed care or insurance companies will pay for.
My second wish would be for our culture to come to better terms with how we wish/intend to care for our elderly. The complexities of a mobile, information age society has contributed to this issue; however, we as a nation must determine a better solution to this growing and shameful dilemma. Until we as a people come to better terms with this issue, perhaps the following wish list can start us off in the right direction:
*Initially, I'd wish for a complete overhaul of the convoluted systems currently used to place individuals in Skilled Nursing Facilities (SNF’s). The emphasis of any new system to replace it should be on providing an appropriate and compassionate level of care, not which Federal funding source will pay for the least amount of high school kids with CNA’s to clean up urine all night and not realistically be able to tend to basic care (such as cleaning and turning patients regularly).
*Next I'd wish would for politicians and legislators to enact laws which would ensure that SNF’s actually provided skilled nursing, and prevented them from pawning patients off to acute care psychiatric centers (cunningly refusing to accept them back) when they demonstrate behavioral manifestations of dementia related conditions. Such legislation should require SNF’s to provide adequate and trained staff to manage such patients rather than exacerbate their condition and disrupt their families with cumbersome, stressful moves that add financial stress and in the end compromise their care.
And finally, I'd wish (given the improbability of my first wish), for our society to recognize and support appropriate approaches to our social ills.
*I wish that we would recognize the short-sightedness of not providing substance abuse treatment to people struggling with addictions rather than dismissing them as flawed characters and putting them in jail or allow them to become homeless.
*I wish that we would recognize that services to children are under attack and rapidly disappearing. This contributes to increasing violence in our culture and an undermining of our basic family structures and our entire society.
*And lastly, I wish that corporate greed in healthcare will be dealt a fatal blow before it completes raping and corrupting the industry, detracting new helping professionals from entering these professions.
This is my holiday wish list. If Santa could make even one of these wishes come true, we could all begin the New Year with a renewed sense of hope.
Happy Holidays.
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