we typically think of acutely and chronically mentally ill patients as those who belong in psychiatric hospitals and the latter category of patients belonging in “regular” hospitals, but the intersection of physical and mental illness draws attention to important challenges for policy-makers and organizational leaders. this article illuminates some broad trends in the health status of people wi...

Economists would have formulated several aspects of the health care reform debate differently than policy entrepreneurs did. Economists would have questioned whether health care costs must be contained and whether either competition or global budgets were a "magic bullet" for doing so. They also would have emphasized the distortive costs of subsidies and taxes necessary to reach universal cover...

After 18 years as a senior clinical psychiatrist at a New England inner-city mental health clinic, Dr Lawrence Climo was understandably surprised and saddened when he was given 2 weeks’ notice that his services were no longer needed. Financial constraints meant the clinic was replacing him with a nurse. Although his wife told him it was an opportunity, he remembers thinking that health care ref...

Virginia v. Sebelius is a federal lawsuit in which Virginia has challenged President Obama's signature legislative initiative of health care reform. Virginia has sought declaratory and injunctive relief to vindicate a state statute declaring that no Virginia resident shall be required to buy health insurance. To defend this state law from the preemptive effect of federal law, Virginia has conte...

Throughout the 1990s, all Latin American countries but Cuba implemented to varying degrees health care sector reforms underpinned by a neoliberal paradigm that redefined health care as less of a social right and more of a market commodity. These health care sector reforms were couched in the broader structural adjustment of Latin American welfare states prescribed consistently by international ...

A Commonwealth Fund survey of adults age 19 and older,conducted from June 2007 to October 2007, finds that large majorities of the public, regardless of political affiliation or income level, say that the candidates' views on health care reform will be very important or somewhat important in their voting decision. Moreover, they believe employers--long the cornerstone of the health insurance sy...

Both the health care sector generally and the alcohol and drug field are moving toward a truly systematic approach to treatment, accelerated by the anticipated advent of health care reform. There is considerable reluctance to develop systems. Many are not convinced of their necessity, and systematization inevitably involves a decrement in autonomy for the components of the system. Nor are syste...

The true measure of health care reform's success is whether it drives down medical costs over the long term. The Patient Protection and Affordable Care Act has several features designed to modernize the delivery of services and thus ensure a more efficient, more effective, and less expensive health care system. These features include bundling medical services into larger payment groups, using v...

This article provides an overview of managed health care in the USA--what has been achieved and what has not--and some lessons for policy-makers in other parts of the world. Although the backlash by consumers and providers makes the future of managed care in the USA uncertain, the evidence shows that it has had a positive effect on stemming the rate of growth of health care spending, without a ...

This paper analyzes the politics of paying for health care reform. It surveys the political strengths and weaknesses of major options to fund universal coverage and explores obstacles to changing how the United States finances health care. Finding a politically viable means to finance universal coverage remains a central barrier to enacting health reform.