Friday, October 31, 2008

Carlat Psychiatry Blog Supports Barack Obama for President

Yes, it’s time for everybody to choose sides.

I support Barack Obama for president, because his positions on mental health care and the pharmaceutical industry make the most sense for the American people.

Positions on Mental Health Care

The National Alliance for the Mentally Ill (NAMI) sent questionnaires to the candidates about their views on mental health issues. You can view the responses of both Obama
and McCain on the NAMI website.
What is most striking immediately is that only Obama bothered to answer the questionnaire, providing specific responses to each of 24 questions crucial to mental health care in America.

McCain, on the other hand, issued a four paragraph generic position statement with few specifics. His mental health plan revolves around controlling costs and calling on Americans to take more “personal responsibility.” For example, he states:

“I have stressed the central role of personal responsibility in leading to lower health care costs. Personal fitness and better lifestyles, especially reduction in addictions of all types – food, narcotics, or cigarettes – can yield dramatic improvements in the cost of chronic illness and high cost medical care. We can do a better job of treating addictions, but we also have an obligation to do a better job of teaching our children the benefits of good lifestyles and the perils of addictive activities.”

Who can argue against personal responsibility? Unfortunately, treating mental illness is a wee bit more complicated than telling patients to "just say no."

Obama has tangibly demonstrated support of mental health treatment by:

--Strongly supporting mental health parity legislation. While both Obama and McCain voted for the federal Mental Health Parity Act, only Obama co-sponsored the legislation. In addition, he actively supported mental health parity in Illinois as a state senator.

--Calling for mental health screening of veterans to treat PTSD and prevent suicide, two growing problems among vets. Ironically for a war hero, McCain has voted repeatedly against increased funding for veteran’s outpatient services, and specifically voted against a provision that would have allocated $500 million for VA mental health services.

Positions on the Pharmaceutical Industry

While McCain has the reputation of being “tough” on drug companies (see this pharma marketing network forum), in reality, Obama supports proposals that would more substantially bring the costs of drugs down.

Both candidates support allowing re-importation of medications from Canada, and both support eliminating loopholes in generic drug law that allow companies to pay generic manufacturers to delay the release of cheaper drugs by 6 months.

But only Obama wants to allow Medicare to negotiate drug prices with companies, which was the crucial element missing from Medicate Part D. McCain has taken no position on this issue.

To summarize, Barack Obama has demonstrated greater leadership on measures ensuring that psychiatric patients receive the care they deserve, and will fight to decrease the inflated costs of prescription medications.


Anonymous said...

I do not get why this is on your blog site. Political statements only muddle the value of commentary that is directed towards different topics.

Disappointing, but you are entitled to "put out your sign".

Like he has an investment in improving mental health issues. Don't hold your breath waiting for him or either party to initiate major gains in our line of work. Let's be honest: mental health does not put out a significant voting block.

Watch George Carlin's last 5 minutes of his "Back In Town" show from 1996. Succinct and so appropriate. He had more to show for not voting than the voters will. Watch the routine, you'll understand what I mean.

Daniel Carlat said...

Every blog should take a stand. Choosing a president is important stuff.

CSR said...

Dan, everyone under the sun already knew you were going to vote for Obama. You're a socialist (anti-capitalist) to the core…just like Barack Hussein Obama.

Why do you think every blogger should take a stand on who they’re going to vote for...I go to many sports blogs and the last thing I want to see is something about politics. Good Americans will do their homework, study the issues and make an intelligent vote. We don't need a blogger giving us their opinion...unless it's on a political blog.

I know this won’t be posted because you never post comments that criticize you. Your blog would be huge if you gave people the opportunity to rip you. There would be hundreds of post per article but people don’t comment because you filter things to favor your cause. Perhaps Obama developed his propaganda machine from watching you.

Ok, you can delete this now and people will just have to read the comments from the 4 people that actually share your cause with you.

Anonymous said...

I voted for Obama to get the opposite of the promises, in accordance with the Immutable Law of Hilarious Political Irony.

Anonymous said...

Health care, health care policy, public health, and politics are crucially related.

You take stands on just about everything, so it seems completely consistent to express your freedom of speech with this endorsement.
Which you back up with your rationale and data from the candidates.

Any physician who does not think that politics and health care are related has not been practicing long enough. The lack of accessibility of health care to millions of Americans is shameful. If only personal responsibility were enough. The entire mission of psychiatry is to help the most vulnerable among us.
Since blogging is your thing, good for you for endorsing a candidate publicly.

Anonymous said...

It is not possible to seperate Mental Health care from Politics, as a large percentage of people with serious mental health conditions will only be able to access government funded services, due to the nature of their psychiatric conditions.

Furthermore, when discussing the practises of pharmaceutical companies, these all occur with regard (or disregard) to what government policy states is appropriae/legal or illegal behaviour. Again, this issue cannot be seperate from the underlying political and economic issues.

Whether I agree or disagree with the views of Dr Carlat, there is little doubt in my mind of the relevance of discussing politics on a blog about psychiatric care and treatment.

As an aside, I think I have just agreed with/found amusing something Supremacy Claus said for the 1st time. The Immutable Law of Hilarious Political Irony is one of the few laws that all sides of politics equally share.

Anonymous said...

As I sit here having lunch, I thought about this posting and some of the replies, and I would like to offer this as an addendum to my above first comment.

While I do not think either major party's candidates have any real substance to their health care platforms, I will say this if Obama wins: if he tries to institute a National Health Care type program, for mental health, just go to your community mental health program near you RIGHT NOW and you'll see it in action, as I do every 20 hours a week I work in it now. To sum it up, it is mostly about just writing scripts and minimal psychotherapy interaction with little substantial progress.

We have a two or three tiered system, and yes, it is unfair and biased. But, to address the above comments about how politics does and should overlap with medical care, it shouldn't and because it does, this is one good reason why medicine is failing. Politics is black and white, right or wrong, has firm boundaries. Does that apply to medicine as a profession, at least in application?

Not last I checked. Every profession has political issues, but do we need to accept Politics in our field. I say no.

Don't forget to vote tomorrow. If you are voting for change, it is NOT just about who will be president. You wonder why so many Senators stay around for, oh, 40 years, like Dr Carlat's own's state's sterling example of Ted Kennedy? So they can just continue to feast off the public. And you think they want to bring their narcissism and sociopathy to the public's attention by aiding mental health care issues? Again, until the mental health population becomes a substantial voting block, ain't gonna happen!

Change isn't just a concept, it's a lifestyle. Accept it, live it, practice it. Sort of the principle of mental health treatment?

Anonymous said...

Describing and evaluating candidates' stands on issues is appropriate for a forum such as this one. However, ramping up to an endorsement implies a one-issue voter, Dan.