Health and Mental Health Care Policy: A Biopsychosocial Perspective Book

Part ONE Introduction

1 of Health and Health Policy

Introduction

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Determinants of Health: A Biopsychosocial Perspective

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Biological Factors

Psychological Factors

Social Factors

Biopsychosocial Dynamics

A Biopsychosocial Approach to Health

Approaches to Health Policy

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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

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The Beginnings of Social Work and Public Health

The Need for Public Health Services

The Mental Hygiene Movement

Compulsory Health Insurance Efforts: 1912—1920

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American Association for Labor Legislation

Establishment of the U.S. Public Health Service

Federal—State Reforms and Private Insurance: 1920—1932

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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

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Maternal and Child Health Services

The Failure to Enact Compulsory Insurance

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

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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

&#lt;blockquote&#gt;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

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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

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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

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State Comprehensive Mental Health Services Plan Act

Stewart B. McKinney Homeless Assistance Act

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

&#lt;blockquote&#gt;Proposals for a Single-Payer Plan

Clinton’s Proposal: The Health Security Act of 1993

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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

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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

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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

&#lt;blockquote&#gt;Quality of Health Care in the United States

Highlights

References

Part THREE The U.S. Health Care System Today

4 Access to Care

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The Need for Access

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What Is Access?

Why Is Access Important?

Trends in Coverage and Reasons for Concern

Health Insurance Coverage in the United States

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Declining Coverage

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Rising Costs

Jobs without Coverage

Changing Work Force

Reductions in Coverage

The Uninsured Population in the United States

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Uninsured Workers

Regional and State Differences

Age

Race and Ethnicity

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Latinas/os

African Americans

Asian Americans

Native Hawaiians and Pacific Islanders

Native Americans

Health Insurance and Utilization of Services

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Differences in Access among the Insured and Uninsured

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Use Patterns by People of Color

U.S. Indian Health Service

Community Benefits: The Free-Care Safety Net

Improving Access to Health Care

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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

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Medicare 1 Choice

Medicare Advantage

Managed Care and Medicaid

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Balanced Budget Act of 1997

State Medicaid Managed-Care Plans

Managed Behavioral Health Care

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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

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Benefits and Financing

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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

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Older Adults

Adults with Disabilities

Women

Managed Care and Medicare

Future of Medicare

Medicaid

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Benefits and Financing

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Mandatory and Optional Benefits

Mandatory and Optional Eligibility

Medicaid Benefit Payments

Recipients

&#lt;blockquote&#gt;Poor and Low-Income Pregnant Women, Children, and Families

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

Personal Responsibility and Work Opportunity Reconciliation Act of 1996

&#lt;blockquote&#gt;Poor and Low-Income Children and Adults with Disabilities

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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

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Demography

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Morbidity

Mortality

Life Expectancy

Epidemiology

&#lt;blockquote&#gt;Health Targets

African Americans

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Life Expectancy and Infant Mortality

HIV/AIDS

Cancer and Cardiovascular Disease

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Cancer

Cardiovascular Disease

Diabetes

Unintentional Injuries: Neighborhood Violence

Latinas/os (Hispanics)

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Life Expectancy and Infant Mortality

Diabetes

HIV/AIDS

Asian Americans and Pacific Islanders

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Life Expectancy

Cancer and Cardiovascular Disease

Diabetes

Native Americans

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Chronic Diseases and Infant Mortality

Alcoholism and Alcohol-Related Mental Health Problems

Environmental Health Risks

Cancer

Racial Differences in the Delivery of Medical Care

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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

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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

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Infectious Diseases

Risky Behaviors: Substance Abuse

Youth Smoking

Youth Drinking

Youth Drug Abuse

Child Abuse and Neglect

Exposure to Violence

Older Adults

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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?

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Inequality and Health

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Absolute versus Relative Poverty

Inequality and Mortality

Explaining the Health Gradient

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Psychosocial Variables

Social Cohesion

Childhood Development

Material Conditions

Conclusion

Implications for Change

Highlights

References

Glossary

Index