Do you remember the "Cultural Revolution" that Mao unleashed in China from 1966-1976? Among other drastic changes, he encouraged young men and women, called the Red Guard, to reform, destroy, and/or kill all that seemed to have to do with high culture and scholars, including parents, relatives, and friends. In a country rich with intellectual accomplishments and scientific discoveries, teachers, artists, scientists and the like were especially targeted. "Barefoot doctors" was an innovation (that proved to be temporary) to serve rural areas instead of training more real doctors.
After spending some time recently in China, it was interesting to hear the mixed opinions on those years, which were similar to the mixed opinions on Mao. (Of course, when one talks with Chinese people in China, you cannot assume they are telling you the truth as they see it, as criticism of the government can get you in trouble). Like any good mental health therapist, you have to listen with a "third ear" and read between the lines. If they say that Mao did 70% good and 30% bad, as I often heard, maybe they really believed just the opposite.
After a period of transition following Mao's death in 1976, China reestablished the value of those targeted, and the current phase of tremendous capitalist growth emerged. The party line is that this is "socialism with Chinese characteristics", but whatever this is called, it is a unique and successful model. So now we have China with the world's second largest economy, basketball star Yao Ming, and the most famous pianist in the world, Lang Lang. Beijing is attempting to become the museum and art gallery capitol of the world. Even psychiatry, and psychoanalysis, is in a growth phase. Of course, like most things, there are side effects and drawbacks, especially severe air pollution.
Some proclaim all this startling development would have started at least 10 years earlier if not for the "Cultural Revolution." Others say that the attempt to make everyone equal (even at a lower level) was a necessary "cleansing," so that development would take off more quickly. Who can know in retrospect? It's like "Monday morning quarterbacking" after a Sunday football loss that is explained by player injuries. It is certainly hard for me to accept that such development was worth the costs of the Cultural Revolution.
Somehow, this got me thinking about our healthcare and mental healthcare reform. As we now know, whatever is emerging from President Obama's reform is coming slowly and minimally, if not surely. What is not changing much is the control and management of the insurance and managed care companies. No public option was included to compete or level the playing field. Do we really think this is going to improve mental healthcare? If the Republicans regain power, the insurance companies are likely to become even more powerful.