Wednesday, August 27, 2014

More Important, Not Less

Center for Medicare Advocacy

Medicare plans to stop approving purchase of speech devices … electronic machines that generate speech for people who can’t speak due to a disability … for people in health care facilities like nursing homes. Picture Stephen Hawking with his voice synthesizer.

The rationale, it seems, is that such facilities provide total care, so it’s less important for the patient to be able to communicate.

The same rationale use to be used … may still for all I know … to refuse purchase of electric wheelchairs and mobility scooters for people in nursing homes and other institutions. Someone in such a facility doesn’t need to be mobile in an institutional setting, because the institution does everything for them.

In both cases, this is a twisted rationale only a penny-pinching bureaucrat could come up with. I’m not knocking penny-pinching bureaucrats. It’s not horrible for someone to ASK whether these devices are still necessary for people in medical facilities. The problem is that other people with some knowledge of health care and disability (including disability rights) should answer that yes, they are necessary. In fact, they may be more necessary since even the “best” institutions tend to curtail patient mobility and healthy activity, and communication is the patient’s best protection from neglect, abuse, or medical error.

Let me say it again … it’s fine to question what some might see as “sacred cows”. But the accountants need to sit down and shut up when the items they want to skimp on are found to be, in fact, vital.

Click the link above to write to your Members of Congress.

When "Despite" Is Really "Because"

Harold Braswell, Washington Post - August 25, 2014

This is a good article on a timely and important topic. I would only add one thing.

I can't prove it, but I suspect that many police and a great many ordinary citizens think that mental illness is actually a justification for deadly force, not a reason to avoid it. It might not always be a conscious belief, but I think a lot of people still associate mental illness (a.k.a. "crazy") with unpredictability and violence. We say, "He shot the man, even though he was mentally ill", while on some level, it's really, "He shot the man because he was mentally ill, and therefore scary and threatening."

Unless this powerful prejudice is directly confronted and refuted with ironclad information and alternative strategies, this kind of thing is going to continue to happen to mentally ill people. I have somewhat higher hopes for change in how police deal with intellectually disabled people, like Ethan Saylor.

There's plenty of stigma to go round, but I think mentally ill people get the worst of it.