With new big money on the table, Michigan’s public mental health services are under assault by privatization forces. Privatization would squander any chance of improving the availability or quality of mental health care for Michiganders. It is the easy and lucrative path for politicians and the healthcare industry. Making these services for-profit would further complicate and dilute the delivery of the services for needy people in their communities.
Privatization forces are currently represented by Senate Bills 597, 598, and 714. Some version of these might come to a full vote soon. According to the most recent episode of Podcast 83 from the Michigan Association of Counties, the sponsors know they might not yet have the votes, but they will keep coming. Bill 714 recently got added in throw-the-dog-a-bone fashion. These bills are rotten at the core and have implications for the state’s $3.6B mental health budget.
So, it is more a war than just this current battle. Privatization has its nose in the proverbial tent by targeting hundreds of millions of dollars associated with Medicaid. But, as the Community Health Care Association of Michigan says, “Mental illness and addiction impact millions of individuals and families across the state of Michigan regardless of their insurance.” There is a failed history of carve outs for mental health services; it has never worked and should not be allowed again, especially given the wider implications.
It is a notable concern that the Governor and the Michigan Department of Health and Human Services are not yet weighing in.
Republicans are full-throated on this; Democrats are not. There is no good reason why these funds cannot be directed to the communities where they are needed. That is the only place where fiscal and delivery performance can be measured. Communities are where innovation can grow, and where the actual care givers and family issues can be supported.
Michigan public mental health services have been positively changing in recent years, and are poised for more. This progress should not be abandoned; this is where the newly available federal funding should be applied.
Mental health services can only be productively delivered in communities with the involvement and respect for families. In the last four years, reform to the Mental Health Code has enabled community partnerships to start forming a system of community care. A continuum of services is required that features face-to-face interaction. Privatization-based bills abandons this progress and takes Michigan in the opposite direction.
Funding and improvements to mental health services were sorely needed even before our radical ongoing increase in mental health issues. The private sector always has a role and needs to be a partner, but it should not be the system owner or receive preferential treatment, as these bills imply. The nature of mental health care brings challenges that the administrative/managed care model (as prescribed by the insurance and healthcare industries) cannot support.
Please reach out to your Michigan Legislator and let her/him know that mental health services need to remain public and not be privatized (made “for profit”). For your convenience, here is a letter you can use with your representative to keep these vital services public.
This effort to privatize mental health care is a Senate bill, meaning that’s where it started. It has to pass there first. This shameful bill is not without some Democratic support. The office of my representative, a Democrat, told me today that there is no “official” stance and no known strategy given that it is a Senate bill. As of now it is in its 3rd reading, meaning they are still tweaking it. Privatization should not fly in any case.