The post above is written by the president of Mental Health America and details his reasons why he thinks opposition to the Murphy Bill is “short sighted.”
Rightly or wrongly this is my take on the significance of his post and the current state of affairs.
1. The mark up showed that on purely partisan numbers the votes probably exist right now to pass the Murphy Bill in the House. Any organization that would repeal the ACA over 50 times could easily pass the Murphy Bill once. The votes are there. That is reality .
2. There is growing recognition that although it is possible the passage of the Murphy Bill as a partisan measure does not make it more but less likely to become the Murphy Law.
3. The opposition at the markup was heard and did have an impact. Deep divisions were evident. Substantial disagreement was evident. Many of the points made by the Democrats were those made by advocates in opposition to the bill. It may not have been Murphy’s biggest nightmare but it was not a great day for Chairman Upton .
4. There remains much talk about addressing “bipartisan concerns.” There is growing recognition that not addressing those concerns before the bill is passed leaves them, in effect, at risk of “repealing the ACA” again and being left with another in a long line of partisan House bills that have little or no effect on reality.
5. If it is simply a question of Republican vs Democrats and nothing else the Murphy Bill can and will pass. The crucial question in moving forward is how it passes.
6. This concern is at least part of the reason for the MHA post. His argument, if I understand it, is that those concerns are already addressed and there is no need for continued opposition.
7. There is some level of recognition if disagreement is not addressed in the House bill those disagreements will be raised to a fever pitch in the Senate and may impact the substance of anything they agree to. Neither Rep. Murphy or the Torrey guys are likely to have the kind of control or influence they have had in the House. In effect if the House does not pass a Senate friendly bill they may be less than pleased with whatever the Senate passes.
8. There is massive pressure on many fronts to pass something . Many organizations that feel like mental health has never been heard at Capital Hill feel like the opportunity is now and fear walking away with nothing. There is a lot of pressure to “pick a team” and, I believe, growing recognition that picking the wrong team may in the end damage the brand of their organization. The organizations that have picked Murphy can’t in a very real and substantial way afford to lose.
9. That fear along with many of the “goodies” in the bill, like for example national standards for peer support and early screening for “mental illness”, make it more likely rather than less that these organizations, particularly since there is no alternative proposals, will support the Murphy Bill if the choice is Murphy or nothing .
10. The pressure to do something is very real and even if there is disagreement on what I don’t think there is disagreement on something. For that reason I think the strategy to simply oppose the bill as a whole and urge that since there are no alternatives that Congress do nothing is an uphill battle at best. I fear also, and I think this is already happening to some degree, that the attempt will be made to marginalize extremely valid criticism as coming from people who “want to just say no to everything.” I could be wrong but I fear I am not. The attempt will be made, has been made, by the Murphy group to say our criticism ignores real problems and leaves vulnerable people at risk. If this criticism resonates with and is bought into by legislators then we will lose.
11. The perspective we need to have legislators buy into is that Murphy’s statement of the problems and issues is narrow and inadequate, that his solutions not only solve little, but do significant harm to the people he says he is trying to help and that better, more comprehensive, more effective, and more ethical answers are possible and indeed called for.
12. I believe the most effective way to attack the bill is to focus on the individual provisions within it. Catalogue and explain the problems they create, the ways in which they are likely to be ineffective, and the reasons why better ideas need to be considered. Every provision of this bill is susceptible to real criticism and it is crucial that legislators see our opposition to this bill is not opposition to reform but a call for a real reform that would help to build a mental health system that would more closely met the needs and challenges of the people that use it.
13. There are people that I know who will say none of this matters. In their view no bill is likely to be passed that addresses many of their core concerns and the most important thing is to continue to press for fundamental reforms that they see as being essential. This is not my position but I view it as a legitimate position to take. Much will not be changed. No bill is likely right now to challenge the over-reliance on psychotropic medication endemic to the system. No bill will likely affect the unquestioned authority of the medical model although a bill that legitimizes and makes trauma informed care and real peer support integral parts of the system may begin to move things in that direction. Injustice and inequity will remain. Any bill passed will not be a solution to fundamental issues. At best it will only be the start of a process that may in time address them.
14. My view though is that it is important to be effective. Things will not just stay the same if a bill passes. Things may in real ways not change in ways I would like. But if the Murphy Bill passes, in anywhere close to its current form, things will get worse and in many ways a lot worse. Equally important it will start us down a path on the national level that is likely to lead to even more regressive legislation. I am less than eager to see Dr. Torrey become the de facto commissioner of Mental Health for the United States.
15. This is a long round about way to say the following :
The Murphy Bill may pass the House but the context in which it passes, if it does, matters.
A lot of organizations have a strong investment in the Murphy Bill passing.
Some of these organizations will find their influence, their credibility and name injured if Murphy loses. (They don’t realize how much they have already lost.)
The post by MHA will not be the last effort to quiet criticism.
There will be problems with any bill passed but there is a lot of pressure to pass something.
The input by advocates has mattered and helped to change the discussion.
If the Murphy Bill passes in anywhere close to its present form it will not only make things worse but will open the door to even more regressive legislation in the future.
WRITE, CALL, EMAIL, TWEET YOUR CONGRESSMAN. YOU HAVE MADE AND WILL CONTINUE TO MAKE A DIFFERENCE. AND IT IS THROUGH THE DIFFERENCE YOU MAKE, THE DIFFERENCE I MAKE, AND THE DIFFERENCE THAT UNTOLD NUMBERS OF OF ORDINARY PEOPLE MAKE THAT WE HAVE A CHANCE TO HELP MAKE A DIFFERENT AND BETTER SYSTEM FOR SO MANY.
Act today. Let your voice be heard.