Generally the first day of the legislature is taken up with housekeeping business. But it often include rallys or other events designed to call attention to a particular cause or subject.  Today was no different.  The rotunda of the Capitol was overflowing with people clamoring for a reinstatement of General Assistance Medical Care, the health care safety net for the poorest of the poor.

There are many reasons to reinstate some form of GAMC; absent the ability to seek medical care most of the people involved will not get preventive care, or even rudimentary medical attention, until their conditions are more chronic, costly and likely to be treated in the emergency room; Hennepin County Medical will be unable to get reimbursed, especially for out of County residents who receive care, and thus will need more subsidy from property taxes; people with heartrending stories of loss, victimization and poverty will be victimized once again; all good reasons in and of themselves.

But there is another reason, that may be more compelling for some who question the others.  In the 1960's and 1970's we had a system of State Hospitals where the mentally ill could be assured of compassionate care.  We closed that system, assuming they would be absorbed into communities.  They weren't.  An interesting phenomonen took place.  The homeless population and the population of our State correctional institutions went up, almost in direct proportion to the decline in State hospital beds.  The correctional facilities and shelters have become a de facto mental health system. 

This is particularly troubling with the prison population because, having been stable, and maintained on appropriate medication during their time incarcerated, they rely on GAMC to provide continuity with their diagnosis and medication once they are released.  Without a means to pay for their medication once they get out (and anyone who thinks MinnesotaCare will work for this population is delusional), they will simply stop taking it, decompose and become unstable.  The least problematic outcome of that will be an increase in nuisance crimes that will result in violations of supervised release and people being returned to costly prison beds.  The most problematic outcome will be those people who, without medication, become totally out of control and hurt others. 

We need to reinstate some form of GAMC or risk a decline in public safety.  This is a trainwreck that is predictable and can be avoided.


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