Friday, February 29, 2008

Cost Alone Should Be a Reason To Be Concerned

Even if they weren't fellow human beings, and even if they weren't overrepresented in scary mass murder situations.

I've read that before deinstitutionalization, schizophrenics were the single largest category of hospital bed-days in North America. That's not mental hospital bed-days--all hospital bed-days. Why? Schizophrenics are about 1% of the U.S. population. But because most schizophrenics become ill in their teens to mid-20s, only about 30% recover, and it doesn't directly kill them--schizophrenics typically have 40-50 years during which they are sick.

I was digging around for more data to fill in one of my stubby little chapters, and I found this disturbing piece of data from a government agency called the National Quality Measures Clearinghouse about schizophrenia:
It accounts for more than 10% of all disabled people in the United States (U.S.) and 2.5% of all U.S. healthcare expenditures. The cost due to society of schizophrenia is enormous (more than $20 billion/year in the U.S. alone).
According to this table, the total monthly disability insurance payments for 2005 was $6,607,972,000--or $79,295,664,000 annually. Schizophrenia thus is costing us more than $8 billion a year just for disability checks. This page indicates that U.S. health care costs were slightly less than $2 trillion in 2005. So health care for schizophrenics (which isn't done all that well, since many are living on the streets) comes to about $50 billion.

Why is this not a major issue in the presidential campaign? I know that there's a lot of research funded to try and understand various mental illnesses. My first reaction to these numbers is that an investment of even $10 billion a year into understanding the causes and trying to find either preventative methods or cures would be a sensible investment.

I've mentioned previously
that The Lancet, the most important British medical journal, a few years back reversed its editorial position about marijuana being harmless because they published a review of existing studies--and concluded that there was a 40% increase in psychosis among marijuana users--and the psychosis came after the marijuana use. This is merely a correlation--perhaps, for all we know, people who are going to become psychotic are attracted to marijuana, and it doesn't really have any effect.

Still, if that correlation does indicate causality, this suggests that Americans are paying at least $23 billion a year extra so that those potheads who don't go psychotic can get mellow and giggle stupidly.

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