Intelligent Budget Cutting

Increasingly police departments are arresting people who are mentally ill, people who do not understand commands, who think they are someone else, who get frightened and act belligerently. Some have been shot and killed in this manner. In Albuquerque 37 people have been shot since 2010, 23 fatally.  Because in some cases the shootings were caught on video, the issue is coming to the fore, not only in New Mexico, but also in other states. Most often officers aren’t trained to handle mental illness, and in most cities they have no back up. Exceptions are few. In Los Angeles, for example, there is a specialized mental health unit and in New York the department has adopted its own form of a crisis intervention model.

A consensus is forming that the underlying problem is related to be the lack of adequate mental health care. Mental health ever since the 60’s has been a budget item that is often cut. According to the NIH, about 6%of the population (one in 17) suffer from a serious mental illness, and while studies show that only 4% of them  are involved in violent crimes, when untreated severe mental illness can be associated with higher rate of violence. The director of policy and legal affairs at the National Alliance on Mental Illness, compared our current practice to what it would it be like to stop treating heart disease until people had heart attacks, except that in mental health treatment is more difficult to begin once people reach a point of crisis.

Cutting budgets is sometimes necessary, we must however cut budgets intelligently, that is with awareness of the consequences, of what happens when these cuts are put into effect.

Today’s Issues

Surely, you’ve heard that the Congressional Budget Office study of the impact of raising the minimum wage to $10.10, would, by 2016, reduce employment by about 500,000 jobs. But it would also lift 900,000 families out of poverty and increase the wages of 16.5 million low wage workers. It’s become ammunition for the right and justification for the left. But beyond that it illustrates how many contemporary issues are not either/or, neither all good nor all bad. Most policies have positive and negative consequences, and whether or not they are constructive depends on placing both sides in context, the way costs/benefits analyses do. Issues have a down and up side. In societies as complex as ours, it is doubtful that any decision, law or policy will be one without the other, will exist without some trade-offs. That’s an old idea, several disciplines have been teaching it in any number of courses for decades. Yet given the nature of today’s political culture using facts to bolster the user’s agenda and today’s media, sounds bites and 140 characters messages, issues tend to be simplified to the point of distortion. Increasingly media sources want attention getters even when those bend, alter, exaggerate, minimize, warp and twist the facts that gave rise to them. And so it’s up to us to remember that with the minimum wage as with almost any issue in today’s economy, it is imperative to avoid seeing them in categorical terms.

Good But…

Everyone it seems praised CVS for their decision to stop carrying tobacco products by next October, even the American Cancer Society highlighted the move on their home page for a time. Industry experts, however, say that the strategy is less altruistic and more of a savvy marketing ploy indicating that CVS is trying to distinguish itself and stand above its competition by promoting its brand as a health care hub in a field that is increasingly relying on self-service. Indeed the reactions and press coverage do give every indication of this being a most successful public relation and marketing move, and begs a question: If their motives and concerns about health were genuine, would their decision mean that in the future we could expect that all products with high contents of sugar and sodium to equally be removed from their inventory? It’s not difficult to surmise that’s rather unlikely. Of course it’s obvious that their motives do not lessen the good removing tobacco products from their shelves can do. Nevertheless, we ought not to be fooled by the seeming altruism of their decision.