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September 17, 2010

Government Drives Us Crazy

Justin Katz

My first thought, upon reading about Butler Hospital's attempts to gain government approval for a 26-bed addition for psychiatric patients was, "Must everything be a controversy?" Unfortunately, the more government involves itself in every corner of American society, the more the answer becomes, "yes."

Psychiatric hospitals around the country have also been expanding, and about a dozen new psychiatric hospitals have been built in the past few years, said Mark Covall, president and CEO, of the National Association of Psychiatric Health Systems, in Washington, D.C.

This is in reaction to a decline in psychiatric beds during the previous decade, the closing of state mental hospitals, and today’s surging demand as insurance coverage improves and the stigma of mental illness eases, Covall said.

The improvement of insurance coverage can be substantially explained, one supposes, by the government parity mandates spearheaded by our own Rep. Patrick Kennedy. And when people feel like they are either getting something for free or paying for it regardless of usage, they'll tend to use it more, eliminating price mechanisms as a fulcrum for supply and demand. What people are willing to pay for becomes moot to the extent that government requires that they (or others) provide financing.

Naturally, it therefore falls to government to regulate usage — whether through quotas, rationing, or the allocation of funds for supply. Thus, when a provider, like Butler Hospital, perceives a shift in demand and seeks to adjust accordingly, competitors, like Rhode Island and Miriam hospitals, and organizations that handle the money, like Blue Cross & Blue Shield, have the opportunity to stop it from doing so through public hearings. The determination, ultimately, is made by unelected bureaucrats, in this case, in the state Health Department, tasked with oversight of the entire system.

Such judges will perforce be drawn from within the industry and, however much they proclaim a narrow focus on the public interest, will be most approached, wheedled, and manipulated by large, powerful entities. Which entity wins, ultimately, is only incidentally related to the well-being of one-voice-one-vote citizens who live and die by the ability to acquire that which they need.