[Psychiatry and psychotherapy in the managed care era: present and future in Israel and learning from the American experience].
The Israeli mental health system is undergoing reform, with privatization being a main component. This involves the transmission of responsibility from state to health maintenance organizations ("Kupot Holim"), similar to the situation in other medical domains, according to the Public Health Insurance Law. It is claimed that the anticipated reform is expected to reduce the quantity and quality of the mental health services that the public will receive. The insuring agencies will inevitably be motivated to save expenses throughout by means of limiting entitlement, access, investment and duration of mental health treatments. A survey of American literature reveals affluence of complaints and critics about the American private mental health insurance system, which may be briefly summarized in that "Managed care companies across the country have treated mental health coverage as if it were a treatment to be avoided at all costs". Henceforth, the prediction that the forthcoming Israeli reform is heading towards reducing the public mental health services which will be supplied to the citizens. This could thereby lead to discrimination between those who can afford private treatment and those who would receive minimal public treatment, if at all.
Gil
Tsvi E
TE
Western Galilee Community Mental Health Clinics, Fligelman Mazra Psychiatric Hospital, Acre, Israel. tsvigil@bezeqint.net
D006801:Humans; D007557:Israel; D007858:Learning; D008329:Managed Care Programs / Q000639:trends*; D011570:Psychiatry / Q000639:trends*; D011613:Psychotherapy / Q000639:trends*; D014481:United States