Legislation pushes involuntary mental health treatment Mental health community divided over issue
By Andrea K. Walker, The Baltimore Sun 11:08 p.m. EDT, March 10, 2014
Mental health community divided over issue
I want to take the discussion of PBIS is schools and move to mental health in the general population. Since PBIS was initiated in schools these few decades we have seen an explosion of children taking mood altering drugs----there is an epidemic of children on Ritalin for example. If you behave differently-----there's a drug for that. It is indeed Fascist and it is promoted by this PBIS format in our schools. What children with behavior differences need are staff to help families learn natural living strategies.
Instead----we have 'there's a drug for that' to increase PHARMA sales and profit.
In Baltimore as across the nation, poverty creates the conditions of many behavior problems. That does not mean poverty is an excuse for bad behavior ------ but we know that physical conditions create human health conditions that cause the bad behavior. For example----roaches and bed bugs infest homes creating asthma and allergies-----lead paint causes brain damage------drug and alcohol addiction causes fetal injury. Chemicals in plastics are now considered a source for ADHD and other behavioral categories. As Reagan/Clinton dismantled public health----and that is on steroids today with Bush/Obama-----our citizens are contracting third world health conditions. Neo-cons and neo-liberals respond with policy that seeks to neutralize and separate with this tiered level of health care. Third world clinic care and lots of PHARMA will control the declining health of a first world citizentry say Johns Hopkins here in Maryland!
So, the corporations creating this third world level of health conditions because neo-liberals and neo-cons dismantled all of our public health agencies.......now want citizens affected pushed away into the cheapest method of care---
IN MARYLAND----O'MALLEY AND THE MARYLAND ASSEMBLY ARE KING OF THIRD WORLD NEO-LIBERAL/NEO-CONS POLICIES AS ARE BALTIMORE CITY HALL!
Common plastics chemicals -- phthalates -- linked to ADHD symptoms
Date: November 23, 2009
Source: Elsevier Summary: Phthalates are important components of many consumer products, including toys, cleaning materials, plastics, and personal care items. Studies to date on phthalates have been inconsistent, with some linking exposure to these chemicals to hormone disruptions, birth defects, asthma and reproductive problems, while others have found no significant association between exposure and adverse effects.
Attention-Deficit Hyperactivity Disorder, Ritalin, Drugging Children, and Psychiatry
NIMH Fails in Its Latest Effort to Endorse Ritalin!!!
Scroll down immediately for many great links.
There are many links to educational pages at the bottom of this brief summary of Ritalin and Attention Deficit Disorder, by doctors, psychiatrists and other professionals.
Ritalin is given to millions of children every year, with the amount growing. Psychiatry has convinced a majority of the public that up to 20% of our children are "mentally ill" and need these drugs to correct their "brain imbalances". Strangely, the behaviors the psychiatrists cite as evidence of the disease have been around as long as children have been getting into cookie jars and running out in front of cars (or should I say "running out in front of horses").
Children are often interested in many things, easily distracted, prone to jump up in sudden interest, or refuse to stop what they are doing. These natural tendencies, which have existed in children as long as there have been children, have been packaged into groups of symptoms, and called Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). Mainly, it's a group of behaviors that certain parents, teachers and authoritarians don't like or can't deal with effectively. So they have given it a fancy name, called this a "mental disorder", and set loose an avalanche of child drugging. The drug companies, who profit greatly by the drugging of children, are often quietly directing advertising and "objective studies" in the background.
It's not that some children aren't incredibly hard to control, disruptive, impulsive and distractible. The situations do exist. The error lies in believing these behaviors to be due to some "mental disorder", which resolve with the modern magical panacea known as drugs. There is much evidence that the true source of the undesirable behaviors are more due to boring classrooms, natural child tendencies and energy, alternate inherent natural learning methods in some children, poor parenting, poor home environment, faulty diet, allergies, environmental toxins, and even poor "matching" between children and parents.
The point is that there is much that can be done in the way of addressing life and taking responsibility for various aspects of life, which often resolves the apparent problems that have been incorrectly called ADHD, ADD or LD (learning disabled). Again, it's not these these "bundles of behaviors" don't exist, but that the existence of them as a "disease", like cancer or arthritis, is a falsehood and an invalid assumption. This is discussed in detail in the articles and chapters below.
We try to tell our children to "Say No To Drugs", and then force them to take Ritalin, a Class II narcotic, very similar in chemical composition and function to both amphetamines ("speed") and cocaine. Ritalin is addictive and subject to severe withdrawal symptoms. It has numerous undesirable side-effects, some of which may be permanent.
Labeling a child with a psychiatric illness has devastating effects on how other people view and treat him or her and how they view themselves. It is also degrading because the child is often told there is "nothing he can do about it". This robs him of responsibility, because it's "not his fault his brain is bad", and the most he can do is 1) accept his disability, and 2) take his drugs (or shock treatments). A child should and can learn to be in control of their behavior. The approach of labeling them with a psychiatric illness tends to deny control, and also the drugging acts to cover and submerge whatever actual problems exist that could be addressed by other, more therapeutic, methods.
The proof that Ritalin and other type drugs don't "cure" any underlying "disease" is that both people with and without the "mental illness" respond the same to the drugs. They both get "off" and "high" in the same way. If there were actually some "brain imbalance" or "disorder", which were being corrected in the "unhealthy" patient by the drug, it wouldn't be expected to have a similar result in a healthy person - but it does. Whatever the drugs do, and the psychiatrists know very little of how or why they work as they do, the drugs do it the same on the "healthy" and "mentally ill" alike. Whatever is occurring, it is not a "cure" for an "illness".
The pages in this section of the web site supply much information on the history, use, abuse, problems and controversy surrounding Ritalin, other child drugging, and the behaviors described by ADD, ADHD and LD.
Click on the links below to open and view the material.
Ritalin: The Drug Time Bomb In Our Schools - educational pamphlet.
The Myth of Attention Deficit Disorder by Dr. Mark Barber
The ADHD Industry by Dr. Mary Ann Block
It's All About Drugs by Dr. Mary Ann Block
America's New Learning Disease by Thomas Armstrong, Ph.D.
A.D.D.: Now You See It, Now You Don't by Thomas Armstrong, Ph.D.
Why A.D.D. Is A Simplistic Answer To The Problems of a Complex World by Thomas Armstrong, Ph.D.
Suppressing The Passion Of Children by Peter Breggin, M.D.
Abandoning The Children by Peter Breggin, M.D.
Saving Your Child From The Label (ADD, or ADHD) by Katherine Taylor Wanamaker (Advice for parents to battle the school system trying to label and drug your child)
What happens in an autocratic society is that people's rights and interests are no longer the drive in policy----what is expedient and most profitable is what trumps. That is what we see in mental health policy since neo-liberals from Reagan/Clinton/Obama and neo-cons from Bush/Cheney have gained control of public policy. It is about medicating-----controlling behavior that is different with dosing. There is an epidemic of this in the military just as with our school children and it is based on the same policy-----expose people to damaging environments and then control the harm to people by neutralizing bad behavior.
Having choices for medication is not a bad thing----it is when it becomes public policy that is it very, very, very, very, very bad.
US military personnel were sorely abused in these decades of war. Emotional scarring would be expected. Neo-con Bush spent his term continuing the Clinton practice of dismantling the public military administration with private military contractors that did not have to treat US citizens under US labor law while overseas-----and like Clinton and now Obama -----privatized the Veteran's Administration so that very little care would be available to these homecoming veterans. We all know the problem with crimes by veterans just as crime within poor communities comes from the abusive public policies ------not the persons in most cases.
THIS WAS PLANNED BECAUSE NEO-CONS AND NEO-LIBERALS WORK FOR PROFIT AT THE EXPENSE OF LABOR AND JUSTICE.
So, in comes PHARMA with a drug for that behavior. THIS IS PBIS.....AND IT IS FASCIST.
Dr. Peter Breggin's Testimony at Veterans Affairs Committee On "Antidepressant-Induced Suicide, Violence and Mania: Implications for the Military"
Dr. Breggin's Testimony Before The U.S. Congress
Read Dr. Breggin's written testimony here. It was also published thereafter
in the peer-reviewed Ethical Human Psychology and Psychiatry.
On February 24, 2010, the Veterans Affairs Committee of the House of Representatives, Chaired by Rep. Bob Filner (D-San Diego) held hearings entitled "Exploring the Relationship Between Medication and Veteran Suicide."
Chairman Filner asked Dr. Peter Breggin to lead off with testimony about "Anti-depressant-induced Suicide, Violence, and Mania: Implications for the Military."
Moments before the hearings began, Chairman Filner visited with Dr. Breggin and explained that he had decided to hold the hearings after reading Dr. Breggin's book, "Medication Madness: The Role of Psychiatry Drugs in Cases of Violence, Suicide and Crime" (2008). He gave Dr. Breggin as much time as he needed in his testimony to set the stage for the hearings. Dr. Breggin provided a detailed analysis emphasizing the science that demonstrates a causal relationship between the newer antidepressants and the production of suicide, violence, mania and other behavioral abnormalities. He emhasized the considerable risk in giving these drugs to heavily armed young men and women.
The hearing video begins with Chairman Filner and another congressman, Dr. Roe, and then Dr. Breggin begins his presentation on the first panel. One other speaker was on the panel, Andrew Leon, PhD, a former FDA official who consults to drug companies. He followed Dr. Breggin briefly, and then the remaining time was spent with the panel questioning Dr. Breggin and Dr. Leon for a total of about 90 minutes.
A second panel featured members of both APAs, and attorney Don Farber of San Rafael, California, who spoke eloquently about the manner in which APA has avoided its responsibilities in regard to medication-induced suicide and the black box warning. A third panel consisted of representatives from the military and the VA.
All of this is why EVERYONE should be concerned about public policy shown below and it is brought to you by the same Wall Street political appointment spending these several years dismantling the public health in Maryland and replacing it with global corporations and corporate non-profits to maximize health industry profits----our Dr Sharfstein. He is known as heading the failed private health system rollout but he could care less about that----his job was keeping the public completely unaware of what he was doing in Maryland Health and Mental Hygiene....and he was good at doing that!
Sharfstein was CEO of Sheppard Pratt before O'Malley chose him to privatize all that is public health to global corporate profit.
He and Johns Hopkins is behind PBIS in our schools and as partners for life----he is behind the most repressive of gun control policies in the nation---Johns Hopkins gun control policy. Hopkins' policy uses the need for good gun legislation and takes it to the dark side as always. Below you see how a neo-conservative institution uses a good issue for very bad policy-----drugging people against their will. They will say the problem with mass shootings is that the shooters refused to take drugs-----but that is rarely the case. Most people refusing drugs end hurting themselves, not others. The people writing these laws and Maryland Assembly passing these laws know this.
Their goal with this involuntary dosing of people is not to protect you and I----it is to control people and as with all autocratic societies, it does not end well for those citizens who behave poorly in the eyes of global corporations.
Below is a good article on the subject----please Google as it is too long to post. It addresses all the concerns and shows that there is almost no research that shows the public policy Sharfstein and O'Malley are promoting for Johns Hopkins is needed-----
'PSYCHIATRIC DRUGS ARE EFFECTIVE FOR FEWER PATIENTS AND ARE MORE HARMFUL THAN COMMONLY BELIEVED'.
02__GOTTSTEIN.DOC 5/27/20081:40:11PM 2008 FORCEDPSYCHIATRICDRUGGING
INVOLUNTARY COMMITMENT AND FORCED PSYCHIATRIC DRUGGING IN THE TRIAL COURTS: RIGHTS VIOLATIONS AS A MATTER OF COURSE
JAMES B.(JIM)GOTTSTEIN* A commonly-held belief is that locking up and forcibly drugging people diagnosed with mental illness is in their best interests as well as society’s as a whole. The truth is far different. Rather than protecting the public from harm, public safety is decreased. Rather than helping psychiatric respondents, many are greatly harmed. The evidence on this is clear. Constitutional, statutory, and judge-made law, if followed, would protect psychiatric respondents from being erroneously deprived of their freedom and right to decline psychiatric drugs. However, lawyers representing psychiatric respondents, and judges hearing these cases uncritically reflect society’s beliefs and do not engage in legitimate legal processes when conducting involuntarily commitment and forced drugging proceedings. By abandoning their core principle of zealous advocacy, lawyers representing psychiatric respondents interpose little, if any, defense and are not discovering and presenting to judges the evidence of the harm to their clients. By abandoning their core principle of being faithful to the law, judges have become instruments of oppression, rather than protectors of the rights of the downtrodden. While this Article focuses on Alaska, similar processes may be found in other United States’ jurisdictions, with only the details differing.
This goes nicely with home health care keeping the poor and working class out of the profit-driven health industry and receiving only care through outsourced private services. Now, if you want to cut down on costs for unruly people-----you medicate them. That's what these same people creating mental health policy these few decades have done with children with behavior spectrum differences. See why Bill Gates moved all his billions into these mood altering medication PHARMA? His PHARMA corporation manufactures and develops all of these meds used in behavioral treatments.
Legislation pushes involuntary mental health treatment Mental health community divided over issue
By Andrea K. Walker, The Baltimore Sun 11:08 p.m. EDT, March 10, 2014
Mental health community divided over issue
Maryland lawmakers are moving to make it easier to medicate mental hospital patients against their will, while examining the idea of court-ordered therapy for mentally ill people who aren't hospitalized.
The legislation is based partly on recommendations from a panel convened by Gov. Martin O'Malley after the 2012 shootings at Sandy Hook Elementary in Newtown, Conn. That case prompted a national debate about the adequacy of care for mentally ill Americans.
But while some mental health advocates have long sought additional tools to better manage treatment — for the sake of the patient and public safety — the proposals have created a rift in the health care community. Some argue such measures are inhumane and unconstitutional.
"This is part of the dilemma in choosing between, on the one hand, necessary treatment, and having high respect for people's individual rights," said Del. Dan Morhaim, the General Assembly's only physician and sponsor of the medication legislation. "We are trying to strike the right balance and really help those who need it."
The state Department of Health and Mental Hygiene supports legislation that would expand the circumstances under which a doctor could medicate mental health patients without their consent. In those cases, as a check and balance, a review must be done by a clinical panel.
Health officials argue that the longer patients go without treatment, the worse their illness and chances for recovery become.
Some lawmakers want further study of a proposal that would allow patients to be forced to get outpatient treatment. They also want an outside panel to study other alternatives, such targeted outreach efforts called "assertive community treatment" that engage those with mental illnesses rather than forcing treatment.
Other measures that would make it easier to have people committed are less assured of passage. One bill would clarify the criteria needed to have somebody hospitalized when they have a psychotic break, but opponents warned the commitment process could be abused. A Senate committee voted against that proposal.
The state health department supports clarifying the standards for hospitalization of mentally ill patients, but it would rather see changes made through regulation, not legislation.
Under the law, patients must be deemed a danger before they can be hospitalized, but practitioners and institutions widely interpret the definition of dangerous.
The health department recently studied deficiencies in the state's behavioral health system that led to periods without care for those with schizophrenia, bipolar disorder, major depression and other conditions. Those breaks can on rare occasions lead to dangerous situations.
"There are some people that may not be in a position where they can make decisions about their treatment," said Dr. Gayle Jordan-Randolph, deputy secretary for behavioral health at the Department of Health and Mental Hygiene, who chaired the panel.
But balancing the need for treatment against individual rights is difficult, experts said.
Forcing people into treatment may not be effective, said Linda Raines, chief executive officer of the Mental Health Association of Maryland. She said it might be more effective to engage patients and help them understand they need help.
"Why don't we give people the option first to let them self-select what will make them better," Raines said.
She called some of the legislation proposed in the General Assembly a "substantial and frightening step backward" that would merely increase the number of people who are institutionalized.
Others say steps must be taken to ensure the mentally ill get the care they need before a crisis occurs. In fiscal year 2012, an analysis of Medicaid data found that 588 people, or less than 1 percent of the state's mental health population, accounted for one-quarter of all emergency department visits. Those patients visited the emergency department six or more times in a year. Many are believed to have a mental disorder called anosognosia, which causes them not to recognize that they are sick.
Some families of mentally ill patients say they can't afford to wait for more studies.
Dr. Steven Sharfstein, CEO of Sheppard Pratt Health System, supports mandatory treatment options because he has seen families desperate to help their loved ones. Doctors sometimes tell them the only way their relatives can get help is if they get arrested, he said.
"Families will tell you about how frustrated and frightened they are because their family member won't get care and how much havoc it creates," Sharfstein said.
The UK has a history of public policy that neo-liberals and neo-cons in the US have been moving towards as quickly as possible.....neo-liberalism moved faster in the UK with Thatcher. We can look at where citizens of the UK are with the policy of forced-medication to see where these policies will go in the US. You see as well that the policies below were inacted in 2008-----at the time of the economic collapse under the guise of cost containment.
NO ONE LIKES THESE POLICIES AND IT IS THE MOST INVASIVE OF ASSAULTS ON CIVIL LIBERTIES.
Remember, these policies are seen to be used systemically and routinely and not in special cases as these people pushing these laws suggest. ROUTINELY FOLKS!
If you ever experience the use of anti-psychotic medication you will see how devastating it is for the person as shown below. For the statistically small number of cases of violence caused by mental illness-----IT IS NOT NEEDED!
Keep in mind that these policies will be seen in Baltimore as Baltimore City Hall is controlled by Hopkins' pols. We need people to get rid of these neo-liberals and neo-cons so we can return to a developed world quality of life!
11 Aug 2014
‘Forced medication is a violent assault’
By guest The Mental Health Resistance Network considers Community Treatment Orders (CTOs) to be a profound violation of human rights and we regard the use of forced medication to be a violent assault.
In the UK we do not inflict physical punishment on convicted criminals yet it is considered acceptable to inject potent chemicals, by force, into someone’s body purportedly in the interests of helping them or, depending on who the supporters of CTOs are addressing, to avoid potential future crimes.
This is despite reports by many of the people who are being drugged that they feel degraded and brutalised by what is happening to them, rather than cared for, and the clear evidence that the risk of being harmed by someone with mental health problems is miniscule.
We know that certain groups within the population are statistically more likely to commit crime but we would never contemplate removing them from society in anticipation of a possible offence. CTOs destroy lives and serve to conceal the lack of proper and meaningful healthcare for people in mental distress. We want to see an immediate end to them.
Although CTOs were already in use in a number of countries, they were introduced in the UK in 2008 following a vigorous campaign by Jayne Zito whose husband, Jonathan, was killed in 1992 by Christopher Clunis, a man diagnosed with paranoid schizophrenia. In 1994, Jayne Zito set up the Zito Trust, strangely referred to as a mental health “charity”.
I recall attending a lecture in the Institute of Psychiatry (IoP) at which she was speaking. She told us that Care in the Community had been a failure. We certainly knew that it was underfunded and was, by and large, a cost cutting exercise, however many people in the audience at the IoP were being cared for in the community and one by one we told her that we were living fulfilled lives within the community and there was absolutely no need for us to be locked up or forced to take devastating drugs.
She seemed not to hear anything that contradicted her message and insisted that society should have the power to drug us against our wills.
As it stood, society already had that power in the form of inpatient sectioning, but she wanted more, that we should not be allowed onto the streets un-medicated. Jayne Zito never argued for an increase in funding for mental health care. She was eventually awarded an OBE.
The introduction of CTOs eliminated the need for the provision of more costly community care or long-term hospital bed occupancy but then gained popular support by being presented as a risk issue through the work of a campaign that I believe was set up in a spirit of revenge.
The Zito Trust greatly exaggerated acts of violence perpetrated by people with mental health problems. Like the rest of the population, people with mental health problems can be capable of violence and this could be regardless of any mental health problem they have. Not all acts of violence by someone with a mental health problem can be attributed to their mental health condition. But at that time there were a few highly publicised killings by people with mental health problems and these were sensationalised by the tabloid press so that, eventually, all people with mental health problems were seen as guilty by association.
The mental health survivor community campaigned against CTOs. I recall attending a march to the offices of SANE were we met with Marjorie Wallace, CEO of SANE, a woman who felt that the first and most important way of treating mental distress was by imposing strict control and discipline on our lives. At the time, SANE stood for Schizophrenia A National Emergency.
Ms Wallace, CBE, was a tabloid journalist and presented mental health issues in the same sensationalist way that the tabloid headlines did. There is indeed a link between mental health and violence and that link is that people with mental health problems are far more likely to be victims of violence than the wider population.
The whole CTO debate was carried out by the tabloid press in a mood of hysteria, headed by quietly-spoken, middle-class, white women, fighting what was presented as a threat posed by big, black, working-class men living freely in the community and not fully under control.
The introduction of CTOs was based on cost-cutting; on asserting the authority of the psychiatric profession; on promoting the pharmaceutical industry as holding the answer to mental distress; on the drive to uphold mainstream ways of thinking of, and experiencing, the world; and on racism and classism.
A disproportionately high number of black men are placed on CTOs. At the time of their introduction, there was little evidence from elsewhere in the world that CTOs reduced the need for hospital readmission or reduced relapse and risk. Recent research confirms that CTOs simply do not reduce hospital readmission or relapse.
We know of one certain case of suicide directly related to someone being on a CTO. Jean Cozens, a founding member of the Mental Health Resistance Network, hung herself in her home on Christmas Day 2012 because her life on a CTO was unbearable. Jean had never harmed anyone. She was told repeatedly that she had no insight into her condition and, after numerous attempts, simply could not get the CTO lifted. Once on a CTO, it is notoriously difficult to be taken off it.
So we are to believe that the drugs acted to help restore her insight, yet years after being on the drugs, she still didn’t have enough insight into her condition to warrant the CTO being lifted at her request. So how long does it take for CTO drugs to restore insight? Or perhaps they never do. (Jean speaks for herself on the video she made two weeks before her death.)
Acute inpatient psychiatric wards are full of people who were fully compliant with their medication regime at the time of their admission. The simple fact is that, for many people, psychiatric drugs just don’t work. This may be because many, if not all, mental health problems are not physical in origin. But the pharmaceutical industry is very powerful and they fund much of what is presented to us as psychiatric care.
The drugs most commonly used in CTOs are antipsychotics. The side affects of these drugs are legion. Tardive dyskinesia, a movement disorder similar to Parkinsons, is often referred to but is more common with the older types of antipsychotic.
The more common side-effects of the newer drugs can be even more devastating. Obesity is very common and it is not unknown for people forced to take anti psychotics to then go on to have gastric bands and bypass surgery. Other side-effects are impotence, depression, a devastating loss of energy, loss of ability to think, loss of ability to experience the full range of emotions, diabetes, nausea… the list goes on and on. It is usually because of these side effects that people stop taking medication and not because of any lack of insight into their condition.
(I have been unable to move from a lying position on my sofa for weeks at a time when taking antipsychotics. This is a particular problem for me as I am diagnosed with schizoaffective disorder, a mixture of psychosis and mood disorder, so while the antipsychotics are aimed at improving the psychosis, in other words dampening down thoughts, the mood disorder is made much worse as I am unable to get on with any kind of life. They have left me feeling suicidal at times.)
One good thing that some people on CTOs experience is that where they would normally be given no care or attention, even when in desperate need, when on a CTO they are assured of receiving some kind of attention from their care team on a regular basis. That people have to submit to this chemical assault on their bodies to be given even the most basic emotional support is a measure of how dire the provision of psychiatric care is.
One last point, in a slightly different vein: in order to obtain the welfare benefits that people with mental distress need to survive, many of us are taking drugs we do not want to take, that are harming us physically, mentally, emotionally, and even making it impossible for us to have children and a social life.
THAT'S WHAT WE ARE TALKING ABOUT AND THAT IS WHERE THESE POLICIES IN THE US WILL GO!
Were it not for our need for welfare benefits, many of us living with mental distress would be very happy to walk away from the psychiatric system altogether and seek appropriate care elsewhere.
Maryland's health reform is all about administration------outsourced consultants needed to determine which outsourced tech corporations will connect with which outsourced medical data sales person for the State of Maryland. Meanwhile, Medicare and Medicaid fraud is still soaring!
Let's simply vote for people wanting Expanded and Improved Medicare for All so we keep everyone's favorite program healthy and we allow all Maryland citizens to be treated as they were living in a developed world. We do not need medical shortcuts to save money-----just rebuild oversight and accountability to
STOP MASSIVE HEALTH INDUSTRY FRAUD AND CORRUPTION FOR GOODNESS SAKE!
Physicians for a National Health Program with Ross Grayson
NEW STUDY: A new study, out today in Health Affairs, finds that hospital bureaucracy consumes 25% of hospital budgets in the US, more than twice as much in other nations.
They also found no evidence that the higher administrative costs in the US lead to better care or any other benefits.
It concludes by saying that #SinglePayer reform could save the US as much as $150 billion annually by eliminating this overhead.
Read the study's abstract and our press release here: http://www.pnhp.org/news/2014/september/bureaucracy-consumes-one-quarter-of-us-hospitals%E2%80%99-budgets-twice-as-much-as-in-ot