Good news! Yesterday the California State Assembly passed the California Health Insurance Reliability Act by a substantial margin—basically along party lines. This is the single payer health care legislation I’ve discussed before, legislation referred to in shorthand as SB840 for which State Senator Sheila Kuehl has been principally responsible. It’s now on its way to Governor Schwartzenegger for his signature. The gov has made noises in opposition to SB840, although he has not said specifically that he’ll veto it. But both the big money of the insurance industry and the Republicans in both houses of the legislature strongly oppose universal health care. To support SB840, you can attend rallies being held in Sacramento tomorrow or contact the gov’s office directly. Information is on the website for Health Care for All at www.healthcareforall.org. This is a big deal. I urge you to take action.
Although SB840 makes access to medical treatment available to every Californian and is a huge step forward, I was reminded by two items in last week’s news of SB840’s limitations in providing real health care. The two news items concerned post-traumatic stress.
A few days ago, Harvard Medical School released a study of Hurricane Katrina survivors. Not surprisingly, the researchers found a dramatic increase in the number of people suffering from post-traumatic stress symptoms: nightmares, anxiety, startle response, anger.
Post-traumatic stress as a diagnosis emerged from the experience of Vietnam War veterans. A little over a week ago, Science magazine published a study that re-evaluated the data on the incidence of post-traumatic stress disorder among Vietnam vets. Previous studies had used self-reporting by vets to determine the incidence of symptoms resulting from traumatic events. Self-reporting is always suspect. The new study instead used military and medical records. It seemed a relief to the researchers that their “objective” measures confirmed the earlier results based on self-reporting. However, the new study found that the percent of vets who had post-traumatic stress disorder was 18%, considerably lower than the 30% estimated in the most widely accepted study to date.
The Washington Post article that carried this story captured what was really behind this study: money. The Department of Veteran Affairs spends around $10 billion each year treating vets for post-traumatic stress disorder. In a companion article to the study in Science, a Harvard psychologist said the study “provides a more accurate gauge of the treatment needs.” Yet a psychiatrist who treated soldiers in Vietnam and spent 12 years directing federal counseling centers said that the study used “a naïve formulation of what represents a trauma exposure and so covers only a small percentage of people actually exposed to traumatic events.”
So the government is trying to dodge paying the price for suffering it caused by redefining who is eligible for the diagnosis. Is anyone surprised?
What this brings up for me is how the issue has been medicalized. The argument is over who gets diagnosed with post-traumatic stress disorder. Without a diagnosis, you don’t get treated because whatever it is you’re suffering from, it’s not post-traumatic stress.
What happened to care? As in health care. People are suffering. Shouldn’t we care for them? This particular form of suffering has fallen into the so-called health care system, which should be called more accurately the medical treatment system. That’s the system that you and I will have better access to when SB840’s single payer system becomes law in California. But it won’t solve the problem of how we get real health care that alleviates suffering.
Related resources are available on the Mind, Mood, and Stress page.
