Against Trans-Substantive Health Care Policy

I understand the impulse, particularly in the area of mental health care and reproductive health care for these red haired children of the main allopathic medical system's institutions and health care coverage.

But, I am not convinced that this is a good approach, not withstanding the undeniable existence of strong mind-body connections in certain kinds of conditions.

From an economic perspective, reproductive health care "naturally" is tied to the entire life cycle. Pregnancies in modern civilization are a few times a lifetime thing, at most, so an annual expenditure oriented health care lan isn't a good way to spread the economic burdens associated with them.

Also, reproductive health care happens to be the focal point of intense, intransigent and enduring political conflicts in our society, while making up only a tiny percentage of total health care costs. 

Insulating this controversial but not very expensive part of the health care system from the ordinary uncontroversial heartland of allopathic medical treatments for predominantly physical conditions, which are exceedingly expensive in the United States, and vice versa, makes sense. A lack of controversy, comparatively, is a good step towards securing widespread public support for the expensive ordinary health care portion which it needs.

Meanwhile, mental health care has very modest functional overlap between the personnel who deal with one and those who deal with physical health. One can be a competent mental health practitioner without having a full fledged medical doctor's education the way that a psychiatrist does, and MD's are an extremely high cost way to provide mental health services that less expensive specialist practitioners could provide just as well.

Also, physical health care institutions, for the most part, are designed, perhaps poorly, for patients with mostly episodic acute afflictions for which the normative treatment is a cure or one time recovery, who can effectively advocate for themselves in a large bureaucratic system or have someone to do so on their behalf.

But, a good mental health care system, almost by definition, needs to meet the needs of patients who often by virtue of the condition that they seek to treat are ill equipped to advocate for themselves in a large bureaucratic system, and are paradigmatically chronic, incurable conditions that are part of who someone is as a person, that need to be managed for a lifetime.

Further, some kinds of care like dentistry, hearing and vision care, while superficially like other kinds of allopathic physical health care, seem to work well with different business models based upon narrow specialization among health care practitioners, relatively non-urgent timing needs for care in most cases, and a focus on continuing maintenance and management of symptoms as much as cures, that make conventional capitalist consumer goods and services business models work better for them than for other parts of health care.

Why take sub-industries of the health care system in the U.S. like dentistry and vision care that aren't deeply broken and try to fold them into the rest of the health care system in the United States which is deeply broken?