Historical textbooks in the future will dedicate a lot of pages to the past couple of weeks. The stock market has gyrated like a drunk knowing not where to stumble. Investment institutions twice the age of man have ceased to exist in minutes in spite of having previously weathered world wars, depressions and the dissolution of empires.
Our elected representatives have voted and the president has signed a bill that is now the law of the land that puts at risk $700 billion of our money.
To "sweeten" the bill to make the medicine go down, the Senate threw in scores of tax-relief gifts and, for good measure, a health insurance provision that mandates that mental health be on a parity with traditional physical health. Now an insurance company cannot put limits on mental-health coverage that they don't have on other illnesses.
This legislative quest of retiring Republican Sen. Pete Domenici from New Mexico began because a daughter developed schizophrenia. Not only did they have to deal with the heartbreak of such a diagnosis, they had to battle the bureaucratic schizophrenia that artificially split the body from the mind.
The 12 years of the legislative struggle was a seesaw between the Senate and House and between those in each chamber who had different opinions and different loyalties. Domenici hosted the opponents to craft a political solution to an expensive personal problem. Even with all these efforts it still took a financial crisis and procedural maneuver to get their efforts before the president.
One can reasonably ask why it takes more than a decade to do something that only seems fair.
Modern neuroscience, modern medicine, modern religion, modern pharmacology, modern culture and societal understanding have all taken mental health out of the Middle Ages. The only ones still in the dark were the insurance industry and their rented servants in Congress. They simply did not want to pay for it. Why spend money on emotionally distressed patients when it could go for executive bonuses or dividends?
Thinking about the crazy system makes a sane person mad. One can only imagine the amount of money, time and golf games that were spent by the high-paid lobbyists fighting the inevitable and the right thing to do. They apparently earned their pay because they were able to hold off the enemy about the same number of years as the Revolution and World War II combined.
But instead of fighting for freedom or against tyranny, this struggle was to prevent ordinary citizens with depression or anxiety or drug problems or like Domenici's daughter's schizophrenia from being treated like someone with diabetes, arthritis or heart disease.
This year so far has been filled with stressful extremes. People are increasingly nervous about their jobs and their financial security. They are engaged in a tumultuous presidential election. Both the president and the Congress are held in low regard. During the current credit anxiety, oil addiction, subprime mania and economic depression, there will be a lot more people who will need the help of doctors, therapists and other psychiatric services to deal with the trauma of their worlds falling apart. Overshadowed by the bailout is still an ongoing war that is producing wounds and casualties of both body and mind.
Post-traumatic stress disorder is not only on the increase in returning soldiers; unemployed stockbrokers may be lining up for the same medicines and counseling.
History will remember the bailout of '08. However, there may not even be a footnote about the years of efforts by the friends of the mentally ill and how Congress finally recognized that the mind is connected to the body. $700 billion can buy a few banks, some toxic loans and a heck of a lot of Prozac. It is just in time because, in this unfolding catastrophe, I wouldn't be surprised if we all end up needing some.
Joseph Cramer, M.D., is a fellow of the American Academy of Pediatrics, practicing pediatrician for more than 25 years and an adjunct professor of pediatrics at the University of Utah. He can be reached at jgcramermd@yahoo.com.