Of Sept. 11, the Uninsured, Anthrax, and Mental Health

John Marcille

Much has been said lately about Sept. 11 and subsequent events, helping Americans place what's truly important in perspective. Worried that your sagging stock portfolio means you'll have to settle for a Lexus rather than a Lamborghini? Get real. We are at war with people whose avowed goal is to kill Americans indiscriminately. We are fighting for our very lives, our families, our cherished freedom. Period.

Even Congress, known to indulge absurdity from time to time, realizes (see Washington Watch) that national preservation outranks, say, debate in the West about fees for recreational use of Forest Service land.

Which brings up a point — there will be a day of reckoning when the anthrax scare is over. Think about it: People taking a $52 drug when a $6 product will do the same thing, as Senior Editor Frank Diamond reports this month; people who may never have been exposed to a single spore downing the stuff like candy, contributing to an already nasty problem of antibiotic misuse; and nobody in charge to remind physicians about this — except maybe health plans that have been struggling with runaway pharmacy expenses.

But I digress. Slowly, appropriately, other important issues will creep back onto the national agenda. One is the plight of the uninsured, the ranks of which threaten to explode with the economic downturn and is a public health crisis waiting to happen. As we report in our cover story, health plans have an opportunity to help control the direction of policy debate on this issue now — before it is controlled for them. The events of Sept. 11, if anything, give insurers an opening, given that funding for incremental expansion of existing programs is likely to dry up.

Another ripening health crisis — what happens when the psychological trauma of Sept. 11 expresses itself in increased stress-related illness? As we report in this issue, it's now time to consider how to streamline appropriate access to behavioral health services.

So, what's important?

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