A young woman dies in childbirth for lack of proper perinatal care. An elderly man can’t afford meds to control his chronic conditions, so he rations them. A child is misdiagnosed in the emergency room. A patient waits months to see her doctor about a troublesome symptom.

Stories like these abound. They are shared by patients, parents, partners, good healthcare providers and others who’ve had enough of medical runarounds, cost issues, access problems, diagnostic and treatment errors, insufficient time with providers, and more, to contend with. Reports of major issues in healthcare by medical professionals as well as patients and politicians with a conscience are increasingly sounding alarms.

In a recent Instagram post, for example, Senator Tammy Baldwin (D-WI) was outraged to learn that drug companies charge as little as $7.00 for an inhaler outside the U.S. while here the price gouging rises to as much as $380 depending on what type of inhaler is needed. Senator Bernie Sanders (I-VT) is among several Democratic senators, and The Senate Health, Education, Labor and Pensions Committee, that have demanded information about asthma inhaler patents and prices from four major manufacturers accused of “manipulating the patent system.”

One of the four companies was cited for charging $645 for an inhaler it sells in the UK for $49. Another company was called out for charging $286 on the U.S. market for an inhaler that costs $9.00 in Germany. According to another Instagram post in February, “Pharmaceutical giant Eli Lilly reported over two billion dollars in profit in the last three months of last year alone. This massive number comes from hiking prices of vital drugs for American seniors and other patients”.

Dr. Ashish Jha, Dean of the School of Public Health at Brown University wrote in a Washington Post editorial in January expressing his concern that some doctors are selling their practices to private equity firms because running a medical practice has become a management nightmare. “The number of private equity firms in health care has exploded in recent years,” Dr Jha lamented. “It’s a trend that should have everyone’s attention, from politicians to patients, because it can significantly increase costs, reduce access, and threaten patient safety.”

In an article published in the New York Times in November last year, Dr. Amol Navathe, co-director of the Healthcare Transformation Institute at the University of Pennsylvania, worried that non-profit hospitals were focusing more on dollars than patients. He wrote that nonprofit hospitals are “hounding poor patients for money, cutting nursing staffing too aggressively, and giving preferential treatment to the rich.” It’s gotten so bad, he says, that nurses and other healthcare workers are resorting to strikes to improve workplace safety at several hospitals during an “acquisition spree” that is making healthcare less affordable.

Nursing homes and assisted living facilities are taking a hit too. According to the New York Times these profitable facilities charge $5,000 per month or more topped up by fees for such things as a blood pressure check, $50 for an injection (more for insulin), almost $100 a month for medication orders from external pharmacies, and over $300 a month for daily help with an overpriced inhaler. There can be extra charges for help in toileting, dining room fees, or a daily check in by staff.

There are currently 31,000 assisted living facilities nationwide. Four out of five of them are for profit businesses. Most of them cater to affluent white elders, although minority groups are a quarter of the population older than 65 in the U.S. According to the New York Times piece, assisted living is “part of a broader affordability crisis in long term-care for the swelling population of older Americans.” Aside from cost issues, there are reports of serious care problems reported by watch groups, ranging from staffing shortages, growing infection rates, and lower vaccination rates in assisted living facilities.

Another area of healthcare feeling a looming crisis is mental health, including addiction. Daniel Bergner, author of the book My Brother’s Story, the Science of Our Brains, and the Search for Our Psyches, points out that while housing, additional psych wards, and community-based treatment facilities are traditionally identified remedies, budgetary and logistical problems are ignored. “These fundamental changes often involve the involuntary nature of care, and the flawed antipsychotic medications that are the mainstay of treatment for people dealing with the symptoms of psychosis,” he says.

Bergner reveals that existing laws in almost all states allow for mandatory care that can rely on court-ordered treatment, including the use of antipsychotic drugs. “Imagine,” he asks us, “being hauled off to an emergency room, forcibly injected with a powerful drug…and held in a locked ward until being dispatched into a compulsory outpatient program.” He points out that is likely to add to a patient’s trauma, isolation, and lack of agency, rather than their recovery. “Compulsory care is deeply problematic…made more so by the medications at its core. … Drugs shouldn’t be the required linchpin of treatment.”

This is just a sampling of the issues confronting our failing healthcare systems. Our disgraceful maternal and infant mortality rates are often linked to racial discrimination. Shrinking Medicaid payments to clinics for the poor dramatically affects healthcare for the poor. And reproductive healthcare is on a rapid road to crises that smack of sexism -- all among the reasons our voices and votes need to be heard this year.

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Here we go again. The so-called experts in psychiatry charged with updating the Diagnostic and Statistical Manual (DSM-5), the less than empirical “bible of psychiatry” that clinicians rely on for reimbursable diagnoses, have decided that six months, maybe a year if they’re generous, is sufficient time to recover from a life-shattering loss.

This pathologizing of “prolonged” grief is yet another example of the arbitrary labeling of human feelings that is present in every version of the DSM, and a reflection of the culture of pathology we have fallen prey to. Big Pharma couldn’t be more pleased as its chemists race to their labs in search of new psychotropic pills. I couldn’t be more concerned about the price women will pay.

Consider this comment by the psychiatrist who chaired the steering committee overseeing revisions to the DSM-5. While being interviewed for a story in the New York Times in March he said, “They were the widows who wore black for the rest of their lives. They were the parents who never got over it, and that was how we talked about them. Colloquially, we would say they never got over the loss of that child.”

The absence of context in that statement is stunning. The widows who wore black were likely not grieving forever; they were more likely observing a cultural norm. And can anyone who has not lost a child begin to understand the emotional agony of that experience? The insensitivity, judgmental language, assumptions, and lack of empathy and context among diagnosticians like that is nothing short of staggering. How can one practice psychiatry devoid of the emotional intelligence necessary to accompany someone on the long, sad journey of grief?

There are psychiatrists, psychologists and social workers who share this view. They are openly critical, arguing that pathologizing a fundamental aspect of the human experience is not only morally wrong, it’s dangerous, warning that being told you have a mental illness when you are emerging from a period of deep grief can add to despair and a debilitating sense of vulnerability.

The backlash against re-defining depression to include grief has been ongoing for at least a decade or more, along with longer term concerns about arbitrary labeling, lack of evidence-based diagnoses, overmedication of patients, and the lack of context in diagnosis, especially for women, who are all too often subjected to meaningless labels like “borderline personality disorder” and “premenstrual dysphoric disorder.”

Women are significantly more likely than men to be diagnosed with a range of psychiatric illnesses. They are also more likely than men to be prescribed psychotropic medication, given electroconvulsive therapy and hospitalized for psychiatric illness.

One of the leading critics of the DSM was the late Dr. Paula Caplan, a pioneering feminist psychologist who resigned from the DSM-4 committee because she recognized that over-diagnosing and overmedication were occurring on the basis of unscientific labeling and diagnosing, especially for women. In a piece she wrote in 2012 in the Washington Post she said, “Since the1980s, I have heard from hundreds of people who have been arbitrarily slapped with a psychiatric label and are struggling because of it.” She noted that “About half of all Americans get a psychiatric diagnosis in their lifetimes which can cost anyone their health insurance, job, custody of their children, or right to make their own medical and legal decisions.”

Others in relevant professions have similar, significant concerns about the DSM. Their concerns include oversimplification “of the vast continuum of human behavior,” misdiagnosis and over-diagnosis “simply because [the patient’s] behavior does not always not always line up with the current ideal,” labeling and stigmatization. The American Psychological Association, the American Counseling Association, and the society for Humanistic Psychology are among the professional organizations who have publicly shared their concerns about the DSM.

Psychiatric care and psychological counseling, of course, have their place in mental health. But practitioners, especially those charged with oversight of the troubling DSM, a reference book some professionals argue should be abandoned, as well as those who seek reimbursement for services, do clinical studies that require funding, and especially those who ignore context or lack sufficient empathy, must recognize their moral obligation to “do no harm.” That includes avoiding judgmental diagnoses, false assumptions, heavy reliance on medication, unhelpful labeling, and inherent sexism.

Paula Caplan had it right when she said “In our increasingly psychiatrized world, the first course is often to classify anything but routine happiness as a mental disorder, assume it is based on a broken brain or a chemical imbalance, and prescribe drugs or hospitalization…. These days you would think there is no such thing as normal.”

Perhaps the next DSM revision should include a new disorder: “Prolonged insensitivity to suffering.” It would be easily diagnosed by an absence of compassion and the overuse of meaningless labels upon meeting new people. Surely no one would argue with that.

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Elayne Clift is a health communications specialist and former Program Director for the National Women’s Health Network. She writes from Vermont.