Letters for your Legislators and Community
During the session, we've talked about the kinds of messages you can get out to your elected officials or to others in your community as a letter to the editor. You can send these as is, or add your own comments about a particular service or experience. Every letter helps build support for accessible mental health care!
Hospital Costs
The direction of the budget discussion has been very concerning to me. As someone who is concerned about mental health care, I know that timely and effective care can make a big difference for people with mental illnesses. Preventive services can cost between $74 and $259 per day. Hospitalization can cost up to $2,500 every day. The proposals by the House and Senate leadership would remove people from health plans that have good mental health care benefits and put them on private plans that might not have any coverage.
Insurance agents would get their commission on policy sales. The insurance companies would get their premium payments. For a 60-year-old person with a serious mental illness earning $8,000 to $14,500 a year (part to full time at $7.25 an hour), their out of pocket medical expense might be $4,400 a year. The reality of such a high deductible is that a person like this might not get much help unless it got so bad the ER had to admit them even without payment. At that point, they would require very costly care. To make up the difference, hospitals hike the costs for the rest of us.
Right now, the plan for mental health care appears to be “pay the wrong people and spend more later.” And that’s just not smart. The bipartisan reforms of 2007 were co-sponsored by Tom Emmer and signed by Tim Pawlenty. Minnesota was starting to cut the number of expensive hospital days, getting more people healthy and in their communities. We know there’s a better way.
Impacts in Outstate Minnesota
Right now, legislators in Saint Paul are arguing over how much to cut from the Health and Human Services budget. They are choosing between bad and awful. Quite simply, I do not believe this represents a fair division of the sacrifice required to balance the budget. I think that keeping hospitals and nursing homes open in rural areas are more important than giving tax breaks to cabin owners. I think that child protection services help us more than property tax refunds for businesses.
The rationale behind not raising taxes is that it would be a job killer. But even Gov. Pawlenty’s former budget commissioner has stated that a modest increase in revenue would present the path of least economic pain. The medical care we provide as a safety net is an employer too: it helps hospitals, providers and consumers from being overwhelmed by the cost of uncompensated care. This is particularly true in rural areas where the county hospital is not just a big employer, it’s a keystone in making an area attractive to new employers and residents. Let’s remember that last time Minnesota “reformed” health care for the poor, there was nothing to help hospitals outside the Twin Cities.
We can choose to pay now, or we can pay more later. Losing health care infrastructure that will be expensive to replace, the jobs lost that won’t come back, and the people who will sink into crisis is just not worth it.
Bottlenecks in the System
One of the themes emerging from the budget debate is that services that aren’t essential are getting cut. What that doesn’t address is the cost of doing nothing. Minnesota can do better when prevention is part of the plan.
Minnesota has one State Hospital left. It is designed to help treat people who still need care after 90 days of hospitalization. Right now, there are patients there who are ready to leave, but can’t find placements for lower level services. If sent home without assistance, these folks are almost sure to come back into the system in crisis. There are other people waiting to get in, stuck in hospitals, when what they need is treatment at Anoka. Bottlenecks like this cost the state a great deal of money.
Instead of making this better, the current House and Senate plans will send more people through the ER instead of a community provider. Fewer people will be able to access innovative services that can help people transition home from or avoid hospitalization that cost around $250 a day. Crisis intervention is $93 dollars per day. A bed at Anoka costs nearly $1,000 a day. A hospital can cost around $2,500 a day.
An “emergency only” system creates emergencies. It means paying more for worse outcomes.
Public Safety (CIT and Access to Treatment)
What’s the biggest public safety impact made by mental illnesses? It’s probably not what you think. While the media has given us plenty of scary images, the real story is untreated mental illness leading to homelessness, chemical dependency, and related problems.
Mental health advocates and law enforcement both support two important initiatives to keep our communities safer. Crisis Intervention Training (CIT) gives cops the tools they need to safely resolve situations where a person has become a danger to themselves or others. After the tragedy of Barbara Schneider’s death ten years ago, police and mental health advocates around Minnesota have made great strides in their ability to respond to these calls and get people the help they need while keeping everyone safe.
Good mental health care and treatment for chemical dependency can help break the cycle and decrease the demand on law enforcement to take people in for creating disturbances or vagrancy. The NIMH estimates that two out of three inmates in local jails need treatment for mental illness. Instead of helping people recover, we pay more for jails.
People with mental illnesses deserve to be treated with respect and have access to the treatment that can help them. Law enforcement needs the training to help everyone get home safely. Taxpayers deserve a system that doesn’t hand them the costs of putting people in jail when it doesn’t make sense.
Job Creators
We have been hearing a great deal about “job creators” recently. In Tuesday’s StarTribune Tom Emmer used the term relating to taxes on the job creators and driving them out of the state. Who are these job creators and what are the jobs they have created?
I know there are many rural hospitals that have a high percentage of jobs in their community. Many of these communities are represented by newly elected legislators who are now in the majority. If some of the proposed cuts to Health and Human Services come about these hospitals will lose jobs in order to keep their costs contained due to their loss of reimbursement, not to say about the uncompensated care they will have to provide.
While these may not be “job creation”, but what about “job maintenance”? Having decent paying jobs in every community leads to a vibrant economy. Any loss of jobs hurts a community.
Mr. Emmer used the term “tax the rich” 5 times in his editorial and, “fair share” once. He said, “fiscal discipline should not be a partisan issue”. Who doesn’t agree with that? That is the basis for the entire budget discussions. It’s how we get there that is in dispute. Without a reasonable tax discussion, we cannot get there. Simply wishing things away doesn’t work. Simply making statements doesn’t work.
Working together works.
Mr. Emmer asks for “selfless, service minded leadership”, not partisan politics as usual. “Smaller, more efficient government” at the expense of our most vulnerable Minnesotans is not good government and not “selfless, service minded leadership."
