Years ago I cared for a patient on a mental health ward who threw a rock through a fire department window intentionally hoping that he would be noticed and arrested.
Why? He had a history of schizophrenia but couldn’t get the care he needed as an outpatient. He could feel himself falling into an acute psychotic state, but did not have needed mental health services, because of underfunding. But he knew that the police had the funding to respond to a broken window and arrest him, which would bring him into jail, out of the cold and, eventually to the attention of psychiatric inpatient services at the expense of the criminal justice system.
I have cared for patients with diabetes, hypertension and other chronic health disorders who likewise sought arrest and detention in order to get the health care they could not afford or arrange outside of jail. I’ve thought of these former patients as I’ve heard the calls to “defund the police.”
It’s worth asking why it is that the taxpayers of the United States seem willing to fund needed care for prisoners that law-abiding citizens can’t seem to afford. Surely we would all be better off if we were to ensure that every American had the health care services that would support active pursuit of life, liberty and happiness through success in our economy and in society, rather than paying for health care only after the criminal system first “enrolls” the patient.
I am all in favor of “defunding the police” if what that means is that we repurpose tax funds currently spent for the ineffective police response to chronic illness, addiction, substance abuse and mental health problems, and instead use those funds to beef up our public health services which actually can reduce the impact of these problems in society.
Truth be told, a health care system fashioned explicitly to organize and fund a doctor for every American family or household (and all the ancillary services family doctors know how to invoke for their patients) could be far less expensive, far less bureaucratic and for more effective than the system we’ve allowed to metastasize from the initial nidus of for-profit, employer-based insurance.
We subsidize this industry with $500 billion each year in tax credits even though it is the source of the exclusionary practices that leave Americans without needed health care services. Eliminating this industry would both reduce health system overhead by $600 billion per year and axe the aforementioned $500 billion per year tax credit subsidy.
What we in Utah could create instead is a non-profit health cooperative which would receive all current health care tax revenues (federal, state and local), assume responsibility for funding all necessary health services for all Utah residents, and free us all from the onerous problems of business as usual in American health care, including massive numbers of patient injuries, poor quality care, personal bankruptcy due to injury or illness and the use of police powers to treat chronic health conditions.
Let’s use this moment in the history of the American search for social justice to demand that Congress get the federal government out of the way of a state solution to our health system problems. Support only those congressional candidates who endorse and will co-sponsor HR 5010 The State Based Universal Health Care Act.
Joseph Jarvis
Joseph Q. Jarvis, M.D., MSPH, Salt Lake City, is a public health physician and the author of “The Purple World: Healing the Harm in American Health Care.” He gladly responds to comments on his website: drjosephqjarvis.com.