When psychoactive drugs were first introduced, there was a brief period of optimism in the psychiatric profession, but by the 1970s, optimism gave way to a sense of threat. Serious side effects of the drugs were becoming apparent, and an antipsychiatry movement had taken root, as exemplified by the writings of Thomas Szasz and the movie One Flew Over the Cuckoo’s Nest. There was also growing competition for patients from psychologists and social workers. In addition, psychiatrists were plagued by internal divisions: some embraced the new biological model, some still clung to the Freudian model, and a few saw mental illness as an essentially sane response to an insane world. Moreover, within the larger medical profession, psychiatrists were regarded as something like poor relations; even with their new drugs, they were seen as less scientific than other specialists, and their income was generally lower.
In the late 1970s, the psychiatric profession struck back—hard. As Robert Whitaker tells it in Anatomy of an Epidemic, the medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported,” and he launched an all-out media and public relations campaign to do exactly that. Psychiatry had a powerful weapon that its competitors lacked. Since psychiatrists must qualify as MDs, they have the legal authority to write prescriptions. By fully embracing the biological model of mental illness and the use of psychoactive drugs to treat it, psychiatry was able to relegate other mental health care providers to ancillary positions and also to identify itself as a scientific discipline along with the rest of the medical profession. Most important, by emphasizing drug treatment, psychiatry became the darling of the pharmaceutical industry, which soon made its gratitude tangible.
First, military spending is discretionary only in name. Real cuts in the Pentagon budget are politically unthinkable in Washington — and besides, Congress this past decade has found a neat way to avoid them. The Middle Eastern wars launched by Bush and continued under Obama — with no real end in sight — are funded by special appropriations outside the official budget process. Congress, despite its obsession with cutting the deficit, has yet to turn down a single one of these requests.
Medicare benefits, by contrast, have been cut repeatedly, while beneficiaries now pay premiums that have only become stiffer over the years. As for Social Security, thanks to the 1983 Amendments to the Social Security Act, workers reaching age 65 in 2025 will get retirement benefits some 19 percent lower than they would have received otherwise. That’s partly because the ‘83 Amendments mandated a gradual rise in the retirement age, and partly because they imposed a tax on benefit income. The payments that retirees receive every month are getting smaller and smaller, meanwhile, since those Medicare premiums are deducted off the top before they go out.
Social spending, then — even when it doesn’t come out of general revenues but from dedicated contributions by workers fro their paychecks, as with Social Security and Medicare — is eminently cuttable, while military spending isn’t. The same goes for public employees and union members, who have seen their bargaining leverage deteriorate for years. While that decline has been arrested from time to time by some — by no means all — Democratic administrations in Washington and the state capitals, the laws enabling workers to organize legally have been steadily eroded for more than 60 years.
what Cory Moll, a part-time Apple Store employee in San Francisco, has come forward with his plan to push for unions for the company’s 30,000 retail employees at 325 retail stores worldwide. Moll started a Web site for his campaign, which, from our vantage point, is currently down (we…