The fate of mental health services in health care reform: II. Realistic solutions.
In the second part of a two-part paper, the three major proposals for U.S. health care reform--the government-sponsored model, the employment-based model, and the market reform model--are reviewed. Barriers to their success include the current economic crisis, the lack of a clear consensus, and the high costs of the proposals. Most proposals limit the extent of psychiatric coverage; some exclude such coverage from minimum benefit packages, an area of concern for clinicians. The author concludes that any substantial health care reform is unlikely in the near future. A thoughtful, realistic, and yet vigorous strategic plan is needed now to forestall the possible exclusion of significant mental health coverage. The basic elements of such a plan are reviewed.
Santiago
J M
JM
University of Arizona College of Medicine, Tucson 85724.
D003363:Cost Control / Q000639:trends; D005544:Forecasting; D015276:Health Care Rationing / Q000191:economics; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics; D017057:Medically Uninsured; D008605:Mental Health Services / Q000191:economics*; D014481:United States