Paul Anderson submits this post:
Iโve heard plenty of talk on here about George Fitchโs brilliant money cutting schemes for Virginia, but not much analysis of what heโs actually going to cut. Iโm impressed with some of his plans (especially the emphasis on subcontracting state services to private contractors, much like Clinton), and not so impressed with others. For example, Fitch has claimed that we can save a boatload of money by cutting expenditures at mental health facilities.
According to a recent Bacon’s Rebellion article:
By way of specifics, Fitch points to the treatment of the mentally ill. The state pays $100,000 a year to treat a mentally ill patient in an institutional setting. By moving patients to local community centers, the state can cut costs down to $30,000 – and improve the quality of care.
$30,000 per patient is way less than $100,000 per patientโฆsounds good, huh? Here’s the problem: I spoke to a friend who has worked in mental health her whole life, and they found this blanket statement to be a bit misinformed.
It can cost less to house people in community centers, but not much less (the numbers he’s using are patently false).
Also, a great deal of the current residents in state facilities are forensic patients. They require more security. There are not comparable places to house them in the community. Jail is not the place you want them. For mental rehabilitation services, my friend told me that community care costs range from $50,000-$120,000 depending on the need. That is slightly less than institutional care (according to Fitch, $100,000 per patient).
As for other cost cutting measures: Lately, the state has been trying to reduce beds to save money, but now there is uproar all over the state, particularly in northern Virginia that there arenโt enough psych beds. This is largely due to the fact that private hospitals are getting out of the mental health business. They make more on medical or surgical beds.
He also fails to face a political reality. There have been repeated attempts to close state facilities. These attempts are always opposed by local politicians, families who use the facilities, and especially employees, because they are a major employer in communities around the state. It just wonโt happen.
The state has a responsibility to provide these sort of mental health services, one way or the other, because as I explained, the private sector doesnโt want to do it. We can move some non-forensic patients into community care centers, and sometimes that saves money, but sometimes itโs just not a good fit for the patient or the surrounding community). But the $30,000 figure that Fitch is using just isnโt realistic.
My main point? When politicians throw out these magical cost cutting numbers, sometimes they havenโt done their homework. You want to cut things? Fine. But itโs going to take tough choices, not easy ones.