Too many clients,...not enough beds.

Same old story I suppose. The City's' public health institutions are cursed by it's reputation as a compassionate and progressive system. We take in and provide care and ongoing treatment of every category along the entire spectrum of mental health and substance abuse services to people from ALL over the country, and at times from other countries...and we do it for free. Very few cities in the nation provide the intensity and depth of treatment and the specialized services that we provide. But the problem is; How do we pay for it all? and will the conga line of patients ever end?

I suppose it may end when public health number crunchers at the federal level come to the common sense conclusion that it is cheaper to provide preventive/primary/tertiary care than emergency services to those who are already "ill". Is social darwinism at work here?...with it's underpinnings set in the Protestant Work Ethic? Is it fair to accept that the rich (or at least those who can afford it) DESERVE better health care because they've EARNED it? And is the opposite then true that those who are poor have not busted their asses, worked as hard, and in turn should NOT receive the same care? I truly believe that this sentiment is working subconciously here. It's an easy way to dispel our outrage and concern...also a mantra of sorts,...say it enough times, and you actually start believing it. And when you throw in the notion of "Finite resources", then you get even the middle class fearing that providing universal health care will negatively impact their families health care.

My goodness, I can really go on and on on this topic, but I don't want to rant. What I can say is that our system is not simply BROKEN...it is at it's core IMMORAL. The moment we introduce "profit" in the situation, we've lost credibility. It's fine to suggest that due to limited resources we may need to triage certain clients based on acuity or need, but to deny treatment due to fiscal reasons is just plain immoral. And I don't need to come up with some apocraphal story for this one....this actually happens every day. It has, and it will happen to each of us in our lives.

Talk to you tomorrow.