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Mental Health Care and National Health Insurance
The burial societies of the Romans were, essentially, private group insurance programs. So were the protection funds of medieval guilds. Largely through the efforts of labor unions, by 1968 more than two-thirds of the labor force in U.S. industry was covered by group life and health insurance plans mostly provided (as fringe benefits) by employers. Today the proportion is even higher, and the establishment of national health insurance, to be sponsored by government, is being debated in the halls of Congress. Complete medical care for the citizenry, with health professionals partly or wholly salaried by a government agency, is now standard in many coun tries, including those of eastern Europe...
Effects of Mental Health Insurance
Using data from the RAND Health Insurance Experiment, the authors examined the effect of mental health insurance on individuals' mental health outcomes, use of mental health services, and economic welfare. Variation in cost sharing induced no significant change over time in mental health status averaged over all beneficiaries. However, there were interactions among plan, initial mental health status, and income. Those with initially good mental health status who were poor had better outcomes under cost sharing than under free care. Those who initially had poor mental health status had a relatively more favorable response to free care, but the research did not determine whether they were abso...
Better But Not Well
This book examines the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness--severe and persistent disorders as well as less serious mental health conditions--are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons. Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs--such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps--and the development of new treatments that are easier for patients to tolerate and for physicians to manage.
Manage or Perish?
"Adapt or perish, now as ever, is Nature's inexorable imperative. " -H. G. Wells, Mind at the End of Its Tether (1946) Doctors are trained to treat people suffering from various diseases. This is the main form of their activity and usually the reason for which they selected medicine as their profession. The notion that they should become managers and engage in activi ties such as programming, calculating cost, assessing cost-benefit ratios, and thinking about pricing in accordance with the social utility of their intervention, is both foreign and abhorrent to them. They are sometimes willing to say how much they need in order to have a well-functioning service: usually they prefer to state w...
