Friday, December 11, 2009

Over-medicating the poor

Rather than race, ethnicity or religion, class is the prism through which I see most issues that affect our society. I think our public discourse is pitifully short of serious discussion on the topic, as some -- those on top of the socioeconomic pecking order -- push the story that there are no classes in America or that individuals can navigate the caste system upward with just a little elbow grease.

But that is one of our national myths. Take this story, for example, from today's New York Times:

New federally financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows.

Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control problems that may be handled much differently for middle-class children?

That's just one of many ways -- some of them out in the open and some, like this, in the shadows -- that working class and poor people are screwed by the system.

1 comment:

N.starluna said...

This is both a structural and social problem. Medicaid pays for meds, they don't pay (very well) for counseling.

But it's also about physicians' own biases. It's a common misconception that poor people are generally non-compliant with anything but taking pills. They believe that poor people couldn't handle counseling so they don't bother working with the family on making counseling work.

This attitude reinforces the pre-existing lack of confidence that many poor people have in dealing with mental health problems. So it all feeds on each other.

There is new research that has found that physicians or health care systems that provide the same support services to poor people as they do middle and upper class people for mental health care get the same results.