The chances are that regardless of who wins the presidential election in
November, looming fiscal deficits will prevent federal spending to improve
mental health services for Americans, political analysts told attendees at the
Opening Plenary of the 2004 conference of the National Alliance for the
Mentally Ill in Washington, D.C., last
month.FIG1
"No matter who wins," said ABC News anchor George
Stephanopoulos, "we will be entering a very dire fiscal situation in
January of 2005—there will probably be a half-trillion-dollar deficit
that will climb over the next four
years."
This deficit, he said, will severely limit the government's ability to fund
any type of health care research or services.
Stephanopoulos is anchor for the ABC News show "This Week" and
served as senior advisor to President Bill Clinton for policy and strategy. He
chronicled his struggle with depression in his 1999 autobiography, All Too
Human (Psychiatric News, June 4).
Stephanopoulos appeared with Robert Boorstin, who is senior vice president
for national security at the Center for American Progress, an institute
dedicated to advancing "progressive" ideas in the United States.
In the 1990s Boorstin served as a White House aide under President Clinton and
has written and spoken publicly about his experiences with bipolar
disorder.
While implementing the recommendations of President George W. Bush's New
Freedom Commission on Mental Health would be "difficult for either
candidate" due to federal deficits, Stephanopoulos speculated that based
on Sen. John Kerry's proposed economic policies, Kerry might be more able to
do so than Bush.
He explained that Kerry's plan to roll back the Bush administration's tax
cuts for those earning more than $200,000 a year "will save another $600
million, which could theoretically be used to invest in things like driving
down the deficit or investing in the mental health commission's
recommendations."
Kerry has said he plans to use the money to provide health care for all
children and many adults currently without health insurance.
Although Bush has said he supports mental health parity, he has not
demonstrated a commitment to mental health issues, according to Boorstin.
"I think you can get a pretty good idea of the president's commitment
to real mental health reform when you examine the commission he appointed and
the fact that he told them to come back revenue neutral, which means, `Don't
spend any money on mental health,'" he said.
"I also think the Bush administration has great trouble making
decisions that run counter to the health insurance industry and the
pharmaceutical industry, and those are the types of industries that will get
hit if [mental health] parity is achieved," he continued.
Another barrier to the progress of legislation that would expand access to
mental health care in the U.S., Boorstin noted, is a political atmosphere he
called "petty and divisive," which is controlled by "extreme
elements in both houses" of Congress.
"Any progress on these types of issues requires people to compromise,
and the current poisoned atmosphere won't allow for that," Boorstin
said.
A deep commitment to mental health issues by members of Congress and other
politicians—many of whom have had a family member with mental
illness—is the genesis of successful mental health legislation, Boorstin
noted.
"It's no coincidence that Sen. Pete Domenici [R-N.M.] and former Sen.
Paul Wellstone got together on this subject, nor that Rep. Lynn Rivers
[D-Mich.] was concerned about mental illness," said Boorstin.
Domenici's daughter and Wellstone's brother have been diagnosed with
serious mental illnesses, and Rivers has been diagnosed with bipolar disorder.▪