Health and Mental Health Care Policy (3RD 10 Edition)

Health and Mental Health Care Policy provides a biopsychosocial perspective on health and mental health care and policy. It examines the legislative and political development of health and mental health care policy in the United States with a focus on the failure to achieve universal coverage and the development of employment-based insurance and managed care. The authors discuss the impact of poverty and inequality on health, examine the health status of disadvantaged and at-risk populations and consider implications for policy and practice.

Part ONE  Introduction      

1 of Health and Health Policy  

Introduction  

Determinants of Health: A Biopsychosocial Perspective  

Biological Factors  

Psychological Factors  

Social Factors 

Biopsychosocial Dynamics 

A Biopsychosocial Approach to Health   

Approaches to Health Policy  

Stage One: Disease and Health Care 

Stage Two: Escalating Costs 

Stage Three: A New Concept of Health  

Stage Four: A New Framework for Health Policy 

Stage Five: Costs and Benefits of Health Policy   

International Policy Efforts  

Implications for Health and Health Care Policy in the United States    

Highlights             

References       

Part TWO  National Health and Mental Health Policy in the United States  

2    The Failure to Enact National Health Insurance: 1865—1946   

Early Efforts to Reform National Health and Mental Health Care: 1865—1912               

The Beginnings of Social Work and Public Health   

The Need for Public Health Services  

The Mental Hygiene Movement  

Compulsory Health Insurance Efforts: 1912—1920   

American Association for Labor Legislation   

Establishment of the U.S. Public Health Service   

Federal—State Reforms and Private Insurance: 1920—1932   

Sheppard—Towner Infancy and Maternity Bill   

The Creation of Blue Cross and Blue Shield and the Veterans Health Administration   

The New Deal Reforms: 1932—1940   

Maternal and Child Health Services   

The Failure to Enact Compulsory Insurance   

Federal Health and Mental Health Policy and Services: 1941—1946   

Emergency Maternal and Infant Care Program   

Public Health Services Act  

National Mental Health Act  

Hill—Burton Hospital Survey and Construction Act

Highlights   

References

3  Emergence of Employment-Based Insurance and Managed Care: 1943 to the Present  

Political Opposition to National Health Insurance: 1943—1950   

The Defeat of National Health Care Legislation: 1943—1949  

The Enactment of Medicare: 1950—1965  

Health Care Inflation and Strategies for Reform: 1970—1988   

Renewed Struggle for National Health Insurance  

The Rise of HMOs   

Regulatory Reform  

Diagnosis-Related Groups  

The Creation and Role of Community Mental Health Centers: 1963—1992   

Mental Retardation and Community Mental Health Centers Construction Act   

Medicaid’s Role in Deinstitutionalization   

Alcohol and Drug Abuse Services   

Consumer Protection Efforts: Patients’ Rights   

Community Support Program 

 The Decline of Community Mental Health: 1980—1992 

State Comprehensive Mental Health Services Plan Act  

Stewart B. McKinney Homeless Assistance Act  

The Rise and Fall of the Health Security Act: 1988—1996  

Proposals for a Single-Payer Plan  

Clinton’s Proposal: The Health Security Act of 1993   

Mental Health Parity   

Why the Act Failed   

Political Weakness of Reformers  

Strong Opposition 

Public Ambivalence and Confusion   

The Aftermath of the Health Security Act: 1995—2003   

Health Insurance Portability and Accountability Act  

State Children’s Health Insurance Program  

Mental Health Parity Act   

Reforming the Veterans Health Administration  

Efforts to Renew Public Health  

Reform during the Bush Years 

Public Health Concerns after September 11, 2001  

Bioterrorism   

Spread of Infectious Disease   

The President’s New Freedom Commission on Mental Health   

Medicare Prescription Drug, Improvement, and Modernization Act of 2003   

Prescription Drug Coverage 

Health Savings Accounts 

Health Care in the 2004 Election 

United States Health Care Costs in International Perspective          

Quality of Health Care in the United States  

Highlights  

References   

Part THREE  The U.S. Health Care System Today   

4    Access to Care  

The Need for Access 

What Is Access?  

Why Is Access Important?  

Trends in Coverage and Reasons for Concern  

Health Insurance Coverage in the United States  

Declining Coverage  

Rising Costs   

Jobs without Coverage  

Changing Work Force  

Reductions in Coverage   

The Uninsured Population in the United States   

Uninsured Workers  

Regional and State Differences  

Age   

Race and Ethnicity   

Latinas/os

African Americans 

Asian Americans   

Native Hawaiians and Pacific Islanders   

Native Americans

Health Insurance and Utilization of Services   

Differences in Access among the Insured and Uninsured  

Use Patterns by People of Color   

U.S. Indian Health Service   

Community Benefits: The Free-Care Safety Net   

Improving Access to Health Care   

Principles of Access   

Expanding Coverage

Highlights   

Websites to Obtain Updated and Additional Information   

References          

5    The Growth and Development of Managed Care   

The Health Maintenance Act of 1973         

From HMOs to Managed Care       

From Managed Care to Managed Competition       

Managed-Care Backlash   

Managed Care and Medicare  

Medicare 1 Choice   

Medicare Advantage

Managed Care and Medicaid   

Balanced Budget Act of 1997   

State Medicaid Managed-Care Plans   

Managed Behavioral Health Care   

Health Care Plans

Carve-Out Plans   

Cost Control   

Parity   

Clinical Practice  

The Future of Managed Care

Highlights   

Websites to Obtain Updated and Additional Information  

References   

6    Medicare and Medicaid  

Medicare   

Benefits and Financing  

Hospital Insurance (Part A)   

Medical Insurance (Part B)   

Medicare Advantage (Part C)   

Medicare Prescription Drugs (Part D)   

Gaps in Coverage and Cost Sharing 

Medicare Benefit Payments 

Beneficiaries   

Older Adults  

Adults with Disabilities   

Women

Managed Care and Medicare   

Future of Medicare 

Medicaid  

Benefits and Financing  

Mandatory and Optional Benefits   

Mandatory and Optional Eligibility   

Medicaid Benefit Payments   

Recipients   

Poor and Low-Income Pregnant Women, Children, and Families  

State Children’s Health Insurance Program (S-CHIP)   

Personal Responsibility and Work Opportunity Reconciliation Act of 1996  

Poor and Low-Income Children and Adults with Disabilities

SSI and Children  

S-CHIP Today   

SSI and Adults 

Medically Needy

 Poor and Low-Income Older Adults (Medicare and Medicaid Dual Eligibles)   

Managed Care and Medicaid  

Highlights 

Websites to Obtain Updated and Additional Information   

References 

Part FOUR  At-Risk and Underserved Populations  

7  in Health: People of Color  

Defining Risk   

Measuring Health Disparities  

Demography   

Morbidity   

Mortality   

Life Expectancy   

Epidemiology   

Health Targets 

African Americans   

Life Expectancy and Infant Mortality   

HIV/AIDS  

Cancer and Cardiovascular Disease  

Cancer   

Cardiovascular Disease   

Diabetes  

Unintentional Injuries: Neighborhood Violence  

Latinas/os (Hispanics)  

Life Expectancy and Infant Mortality  

Diabetes  

HIV/AIDS

Asian Americans and Pacific Islanders  

Life Expectancy   

Cancer and Cardiovascular Disease   

Diabetes

Native Americans  

Chronic Diseases and Infant Mortality   

Alcoholism and Alcohol-Related Mental Health Problems

Environmental Health Risks  

Cancer  

Racial Differences in the Delivery of Medical Care   

Infant and Child Health   

Heart Disease and Stroke  

Cancer   

Diabetes   

HIV/AIDS   

Highlights  

Websites to Obtain Updated and Additional Information   

References 

8    Disparities in Health: Gender and Age-Based Differences    

Women and Infants 

Cancer and Cardiovascular Disease   

HIV/AIDS  

Maternal and Infant Mortality  

Maternal, Prenatal, and Child Health Services 

Family Planning Services  

Violence against Women  

Depression  

Women in Medical Research   

Children and Adolescents   

Infectious Diseases   

Risky Behaviors: Substance Abuse 

Youth Smoking   

Youth Drinking   

Youth Drug Abuse   

Child Abuse and Neglect   

Exposure to Violence   

Older Adults   

Long-Term Care   

Elder Abuse   

Older Adults in Medical Research   

Highlights   

Websites to Obtain Updated and Additional Information   

References   

Part FIVE  New Directions for Health and Health Policy   

9  Beyond Health Care

What Determines Good Health? 

Inequality and Health  

Absolute versus Relative Poverty   

Inequality and Mortality   

Explaining the Health Gradient   

Psychosocial Variables

Social Cohesion   

Childhood Development  

Material Conditions   

Conclusion

Implications for ChangeHighlights  

References  

Glossary  

Index