Increasingly over the past 15 years, the concept and philosophy of a “system of care” has provided a guide and organizing framework for system reform in children’s mental health. As the field has begun to consider the action steps needed to improve children’s mental health services in today’s environment, much consideration also is being given to examining how the system of care concept has evo...

This paper examines political feasibility and its implications for health reform. I discuss the political obstacles to health reform in the United States, disentangling perennial barriers from contemporary constraints. I then explore major reform options and their political prospects. I argue that while incremental reform now appears to be the most feasible option, the political climate may cha...