Psychiatry and Pain Management’s soaring profits since 1990 were fed by a unique combination of favorable circumstances never before seen: First, they’re paid mostly by federal funds. These include Medicaid, Medicare, and tax subsidies for employer-paid healthcare. But unlike other federally subsidized industries, health industry goods and services are covered by insurance, so high costs don’t deter client use of them. Just imagine all the fine food and posh restaurants we would access if we had hunger insurance that paid for them.
Mental health and pain treaters have advantages over other industries that rely on insurance payments: Medicare and Medicaid, being federally funded, are able to spend endless public money with few restrictions on coverage, regardless of cost. For example, Medicare costs jumped after a 2008 law raised mental health reimbursement from 50% to 80%.1 Private health insurers tried to rein in rising mental health costs, but were blocked by 1996,2 2008, and 20103 parity laws that forbade mental healthcare limits, copays, deductibles, or certification requirements from being greater than for physical care. This is part of why private insurance is now so costly.
To tap into this endless money, the pain and ‘mental illness’ fields made use of another advantage: Unlike events covered by other types of insurance, an illness is an arbitrary concept. Doctors can thus broaden its definition in order to broaden their domain: It can be a subjective physical perception with no clear or treatable source. For example, chronic pain became an illness. Illnesses do not even need to be physical: Painful thoughts and feelings, and kids acting like kids, also became illnesses. This was endorsed by a 1992 law4 that granted funds for services for the ‘one quarter who will suffer from mental disorders’, and for biomedically-focused mental illness research to be done at the NIH.
So, unlike other insurers that can verify house fires, car wrecks, or death, health insurers can’t verify mental illness or pain. Unlike other MDs, psychiatrists and pain doctors can invent infinite chronic (and thus lucrative) illnesses. Each client can be labeled with many different ones; there’s no limit. And each illness can justify a doctor’s luring the patient into lifelong addiction to euphoria-giving pills.
These MDs can also pad profits by putting clients on disability: Clients will then return regularly/eternally to prove ongoing disability, to ensure that their SSD checks and food/housing/healthcare assistance continue. Since they won’t work, they’ll have the time (and health insurance) to do so. A 1984 law5 made adult disability approval hinge on subjective functional impairment instead of objective disease evidence; this made mental illness (or chronic pain) easier to get SSD for. In 1991,6 the Social Security administration made child disability also hinge on functionality instead of illness proof. Child SSI cases rose five-fold soon after, mostly for mental illness.7 So illness-creators opened doors to disability benefits as well as insurance cash; that’s convenient, since their addictive ‘meds’ make it hard to work.
Two 1990 laws8 9 specified depression, ADHD, etc.to be valid causes of disability (before then, schizophrenia was the only ‘mental illness’ considered disabling). This further eased access to SSD/SSI funds. These laws also rewarded these illnesses by making life-easing accommodations available to those who ‘have’ them. For example, Billy prefers to play video games rather than do homework. By getting him labeled ADHD, his busy parents and teachers won’t have to struggle to teach him good work habits, since he’ll now be given less schoolwork (he’ll also be drugged into submission, so he won’t need to be raised). And his label may qualify his family for SSI, Medicaid, and other benefits.
400 million addictive prescriptions are filled yearly.10 It’s caused so much addiction and overdosing, including among kids who steal their parents’ pills, that the lifespans of white Americans have dropped steadily (they use 2.5 times as many psych11 and opioid12 ‘meds’ as non-whites). Then a 2000 law13 authorized doctors to treat the addictions they caused with yet more opioids (suboxone, or prison heroin). It’s such blatant drug-dealing that this law had to be enacted to make it legal (it circumvented a 1914 law14 that criminalized the prescribing of opiates to maintain addicts’ addictions). Suboxone is often peddled at drug rehabs, where clients thus score rather than quit drugs. Since the 2008 parity law made insurers cover treatment for addiction the same as for physical illness, these rehabs make a killing.
Mental health treaters capitalized on all these favors to become our most costly healthcare sector15 and a major cause of healthcare becoming our government’s top expense and top tax subsidy. Costs of other government programs also spiked, due to mental health, pain, and addiction treaters baiting and trapping millions into reliance on Social Security and other benefits. Since 2016, Congress has had to divert funds from the SS retirement to the SS disability trust fund,16 since the latter couldn’t keep up with all its mental illness and chronic pain claimants (its main recipients17). Businesses cut full-time workers in order to avoid paying their costly healthcare as is required by law. This drove yet more people to seek federal benefits. Nearly a fourth of Americans are on Medicaid now.
Psych drug and opioid prescribers are bankrupting us and exploding our debt. We spend more on healthcare and its addictive pills than all other nations, yet are still pounded by propaganda about “millions suffering needlessly from untreated mental illness.” Things will only get worse; many more mental health laws are on the way. 18 19 20 21 22 23 24 25 26
Something similar actually did occur before: The British East India Company, aided by England’s parliament which invested in it, bailed it out, and made laws giving it monopolies, dominated trade in the East in the 1700s. It helped spread British colonialism there. In the 1800s, it profited greatly by growing opium in India and selling it in China. This hurt China’s economy by siphoning its silver and turning industrious Chinese people into idle, unproductive addicts. Its emperor finally halted opium imports after his son (China’s prince) died of an overdose (as did our “Prince”). The BEIC reacted by conquering, with British assistance, all Chinese ports and nearby areas, in order to ensure continued opium selling. This began what China calls its “century of humiliation” in which a great empire was brought to its knees and subjugated by England, France, and Japan.27
Are we at the start of our own lost century, with psych pill and opioid dispensers taking on the BEIC’s role? Like our drug-dealing doctors, it succeeded largely due to close alliance and support from its government every step of the way. The only difference is: Our own healers and leaders are killing us!
- Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 ↩
- Mental Health Parity Act of 1996 ↩
- Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 ↩
- George Bush, XLI President of the United States: 1989-1993, Statement on Signing the Alcohol, Drug Abuse, And Mental Health Administration Reorganization Act, July 10, 1992 ↩
- Social Security Disability Benefits Reform Act of 1984 ↩
- Clark, J. “Determining Disability for Children: Implementation of Sullivan v. Zebley: Part I: The New Sequential Evaluation Process – An Overview” Mental Health Law Project, National Clearinghouse for Legal Services, 25 Clearinghouse Review 246, Jul 1991. ↩
- “Fast Facts and Figures about Social Security Benefits” Social Security Administration, 2016. ↩
- Americans with Disabilities Act of 1990 ↩
- Individuals with Disabilities Education Act of 1990 ↩
- “The Latest Prescription Trends for Controlled Prescription Drugs” Jones, C, U.S. Food and Drug Administration, Drugabuse.gov Sept 1, 2015 (from IMS National Prescription Audit). ↩
- SAMHSA “Racial/Ethnic Differences in Mental Health Service Use among Adults” 2015. ↩
- Singhai, A. et al, “Racial/Ethnic Disparities in Opioid Prescription at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse” PLOS One, Aug 8,2016. ↩
- Drug Addiction Treatment Act of 2000 ↩
- Harrison Narcotics Act of 1914 ↩
- Roehrig, C. “Mental Disorders Top the List of the Most Costly Conditions in the United States: $201 Billion” Health Affairs, June 2016, vol 35,6:Behavioral Health ↩
- Joel, A. “Budget Deal: SSDI Gets a Bailout from the Social Security Trust Fund” Redstate.com, Oct 29, 2015. ↩
- Annual Statistical Report on the Social Security Disability Insurance Program, 2011. ↩
- Helping Families in Mental Health Crisis Act (HR 2646) ↩
- Bringing Postpartum Depression out of the Shadows Act (HR 3235, S 2311) ↩
- Ensuring Children’s Access to Specialty Care Act of 2015 (HR 1859) ↩
- Children’s Recovery from Trauma Act of 2015 (HR 2632, S 1494) ↩
- Mental Health in Schools Act of 2015 ↩
- Mental Health Awareness and Improvement Act of 2015 (S 1893) ↩
- Family Stability and Kinship Care Act of 2015 (S 1964) ↩
- Garrett Lee Smith Memorial Act Reauthorization of 2015 (HR 938, S 1299) ↩
- Children’s Access to Mental Health Services Act (HR 5462) ↩
- “The Opium Wars: The Bloody Conflicts that Destroyed Imperial China” Roblin, S. The National Interest, Aug 1, 2016. ↩
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.