I got a call the other day from my old pal Leo. He checks in occasionally to see how I’m doing and inquire about our next lunch date, but he mostly likes to remind me how poorly my preferred politicians are faring in the most recent polls. The longtime conservative political commentator and world-class raconteur hopes to get a rise out of me, but I seldom take the bait anymore.
“All the polls are showing big gains among Republicans in the swing states,” he noted cheerily. “It looks pretty bad for the Dems in the midterms.”
I paused for a moment to let him think I was gathering steam. “That’s interesting, Leo,” I said. “But you know as well as I that the only Poles you can trust are the ones living in Warsaw.”
Such retorts usually bring a chuckle and a change of subject matter. There was a brief silence. “So . . . are we going to see a baseball season this year?” he offered.
Leo is a political junkie. I once claimed to be and willingly sparred with him over everything from Clinton’s welfare reform to Bush’s invasion of Iraq, but the body politic in recent years has become so toxic that civil debate seems an outworn relic of some vaguely imagined past. And, as Michelle Goldberg opined last week in the New York Times, it’s stressing everyone out.
“The crisis,” she writes, “expresses itself in all sorts of ways: in rising rates of youth suicide, record overdoses, random acts of street violence, months-long waiting lists for children’s therapists, mask meltdowns, QAnon.”
Citing a survey conducted between March 2017 and November 2020 by Kevin Smith, PhD, at the University of Nebraska, Lincoln, Goldberg reports that 40 percent of respondents admitted the political climate triggered varying levels of stress. As many as one in four polled confessed to engaging in self-destructive or compulsive behaviors as a result of following political news.
Smith’s study doesn’t break down responses by age group, but we can assume a fair portion of the senior set struggles with this issue as well — which makes a new survey by the Commonwealth Fund particularly intriguing.
Polling more than 18,000 adults over the age of 65 in the United States and 10 other high-income countries between March and June 2021, researchers found that Medicare beneficiaries were more likely than seniors elsewhere to suffer from a diagnosed mental-health condition during the preceding 12 months. And they were also more likely to encounter financial hardship while trying to pay for the treatment.
Some 20 percent of the Medicare set reported a diagnosis of depression, anxiety, or other mental-health conditions. More than one in four of those diagnosed said they couldn’t afford the needed services to mitigate the effects of their illness.
“Despite the financial protections Medicare offers, its coverage leaves many U.S. older adults exposed to high healthcare costs,” the authors explain. “This is particularly true for beneficiaries with serious mental-health needs who are likely to spend more on health services. High out-of-pocket costs can lead beneficiaries to postpone care or forgo it entirely, which can produce poorer health outcomes and raise overall healthcare spending.”
Among the financial roadblocks U.S. seniors face are higher out-of-pocket costs for antidepressant and antipsychotic drugs, a dwindling number of psychiatrists who are willing to accept Medicare patients, and Medicare policies that limit lifetime coverage for inpatient psychiatric hospital care to 190 days. Telemedicine, popularized during the pandemic, could greatly expand access to mental-health services, the authors note, but Medicare limits its coverage to those living in rural areas.
Seniors fare much better beyond our borders. Those seeking mental-health services in Canada, Germany, the Netherlands, the United Kingdom, and other functioning social democracies pay nothing for primary-care visits. Canadians requiring prescription drugs to treat a mental-health condition face no copays. In France, those suffering from long-term chronic mental illnesses receive their treatment at no cost to them. And the Australian government subsidizes therapy sessions conducted by psychiatrists, psychologists, and even general practitioners.
All this government support, the authors conclude, produced a logical result: “Fewer than one in 10 older adults with mental-health needs in the United Kingdom, France, Sweden, and Germany reported skipping or delaying needed care because of costs.”
I could bring this up, I suppose, the next time Leo goes on about those Bolsheviks in Congress who keep pushing for “socialized medicine.” But I don’t want to raise his anxiety levels beyond their often stratospheric heights. Besides, I’d rather talk a little baseball.