Once upon a time long ago public education and public health programs in California were among the best of their kind in all of America.  Outpatient mental health clinics in California served as models for other states. California elementary schools and high schools were among the best in the nation. Public colleges and universities were among the best in the world. Of course, the programs were expensive; but California’s economy was healthy.  On the national stage, in 1964 a Hollywood actor delivered a rousing speech in support of the candidacy of Barry Goldwater for the American presidency.  Ronald Reagan was so eloquent and persuasive in his plea for support of Goldwater (who lost the election anyway to L. B. Johnson) that he was persuaded by California Republicans to run for governor in 1966.  Reagan won the election and served two terms, 1967 to 1975.  Reagan ran on a pledge to lower taxes. He made good on his promise.  One of his very first acts as governor was to close all the states mental health outpatient clinics. The mental hospitals were full so outpatients who ceased to get care couldn't be transferred to inpatient facilities.  If patients’ families couldn't afford private care, they went untreated.  1967, the first year of Reagan's governorship, was the year when the population of homeless people began to grow, and the growth has been steady up to the present time.  Californians soon learned that poor families with no health insurance had no way to cope with severe mental illness, and middle income families usually couldn’t afford expensive private outpatient care because health insurance policies rarely covered mental illness. 

I was reminded today of what can happen when healthy people and governmental leaders turn their backs on the poorest and the sickest of our citizens. I saw someone today who reminded me how far my nation has fallen as a civil society.  A woman in rags, clearly homeless and obviously mentally ill, was wandering along a major avenue in San Diego. Most homeless mentally ill citizens are mostly unseen.  Most are not  roaming out on public streets but are under bridges, in hidden recesses of parks, or huddled against buildings in the center of the city.  

No citizen living in the wealthiest nation in the world should ever be left to wander without health care as this woman is doing. Explanations about how her family has failed her, or how she may have used drugs, or how she may not have looked hard enough for work can serve as adequate excuse for our not having a program that could have kept her from being in this terrible condition. I am ashamed and embarrassed to know that we are becoming known in the world as the rich beautiful nation that doesn't adequately care for its citizens.