He just writes a syndicated newspaper column.  But this doc raises a critical issue when it comes to treating a mental health problem.

Peter Gott, M.D., isn’t a psychiatrist.  But in a recent column, a reader had been advised by his family doctor to take an antidepressant.  The reader worried about serious side effects.

Yes, Dr. Gott said, these medications, while generally safe,  have side effects, some unpleasant.    But before taking an antidepressant, the he advised the reader to consult a psychiatrist.  Why?  Because that specialist has lots more experience dealing with the side effects of these medications.

Maybe that’s not always the case.  After all, family doctors do regularly prescribe psychotropic medications.   Lots of them.  And people with depression, for example, more likely seek out the family doctor for help first.  So the family doctors aren’t lacking in experience.

There are two problems, though.   One is they don’t have the extensive training in a field that’s highly complex.  More important, they’re often so rushed, they don’t spend enough time with the patient to fully understand a patient’s mental health problems.

Research shows that family doctors miss a diagnosis of mental illness in about half the cases.  And when they get it right, they prescribe the wrong medication.  But the answer isn’t for the family doctor to routinely ship every person who seems depressed off to a psychiatrist.

A better approach comes from the University of Michigan’s Depression Center.  For the past year, the center has been overseeing a pilot program for family doctors in Flint, Michigan.   The program takes as a given the rush the typical general practitioner is to see each patient.  So this pilot program has assigned a nurse specialist to advise the family doctor and follow the patient’s treatment throughout its course.

If there’s a shortcoming to this program in Flint, it’s that so many people still fail to discuss mental health problems with the family doctor.  And they sure don’t want talk to a psychiatrist.   This powerful stigma means lots of people suffer when they could be helped.

But Dr. Gott’s open discussion of mental health is the sort of thing that can overcome the stigma.   Truly, there is help.

I just knew Senate Democrats would stick together and pass the move to bring up health care for debate on the floor.

And I figured Republicans would stand together against holding the debate. No lone member of the Grand Old Party would give the go ahead to this historic debate on a matter that affects all Americans.

Frankly, Americans shouldn’t be surprised.  With few exceptions, Republicans opposed the creation of Social Security.  They opposed Medicare.  They were against Medicaid.  They opposed the Great Society programs, such as food stamps and Head Start.    And in this debate, we’ve heard the most outrageous claims, yes, lies from Republican leaders.  They’ve stoked divisions and fostered ignorance.

That’s been the party of Lincoln since the Great Depression – and before.

You’d think the opponents of health care reform would want to get the issues out for a full, robust debate.  You’d think they’d want a crack at changing things they didn’t like about the bill.   Only one House Republican joined a narrow majority of Democrats to pass the more comprehensive bill.  No GOP help in the Senate.

Well, there’s going to be a debate. It will last through the holidays, maybe into the New Year.  But what should promise to be an inspiring, enlightening exercise in democracy likely will be a replay of the acrimony and demagoguery that have characterized the Republican contribution to this point.   So there you have it.  The GOP, once again, on the wrong side of history.

I don’t believe it.  Now critics of health care reform claim that the new screening recommendations for breast and cervical cancer claim these are the prelude to rationing health care.

This is too much. Here these independent panel of cancer experts issue their reports completely independent of the legislation moving through Congress. Their recommendations are advisory, not prescriptive.  This is rationing?

You want hear about rationing.  What of those with serious disabilities who don’t qualify for Medicaid. I know persons with a mental illness who get turned down or just don’t apply for the government run program. So they don’t have health insurance. Any. Even if they’re working, it’s likely at low-end wages that don’t come with health insurance.

Besides, Congress can always tell insurance companies they can’t dictate at what age they’ll pay for cancer screening.

As for rationing health care: What do the critics think is going on now?

I just ordered new hearing aids. They cost around $5,000. The aids let a person hear plays, music, TV and what your wife just asked you to do.

Thank goodness, I can afford to buy the new aids. But I won’t get a penny toward this considerable expense from Medicare or from my Medicare Advantage plan.

Yet thousands of elderly persons who have major hearing loss, and have no income beside Social Securitysimply do without. Never mind that this is a real, disabling health problem.

This group falls into that category of “under-insured.” And if you add these folk to the nearly 50 million who have no health insurance, you can tack a few more million.

Medicare rations care. Private health insurance rations care, whether you pay or your employer.

Without health insurance, millions of people don’t get health care, at least not when they need it.

Without health insurance, thousands die needlessly ever year.

This is what the debate should focus on. This is what it’s all about. And the lack of health care in a country so rich, so blessed in a thousand ways, is a national disgrace.

For my part, the issue isn’t the cost of health care reform. It’s not the public option. It’s not the deficit. (AS if Iraq didn’t.) It’s about people. It’s about people needing help. It’s about people get sick. It’s about people become disabled. It’s about everyone who doesn’t have health insurance crying out for help and no one, no one is listening.