Applying Health Care Reform Principles to Mental Health and Substance Abuse Services

Published In: JAMA, The Journal of the American Medical Association, v. 302, no. 13, Commentary, Oct. 7, 2009, p. 1463-1464

Posted on RAND.org on January 01, 2009

by Kavita Patel, Kenneth B. Wells

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The US political system is debating the desirability and feasibility of health care reform. Discussions focus on expanding coverage while reforming delivery to contain costs and ensure quality, but there has been little discussion about how to apply reform principles to mental health and substance abuse (MHSA) conditions and services. The passage of federal parity bills for private plans and outpatient Medicare services underscores the policy interest in ensuring financial access and the timeliness of considering application of reform principles to these services. This Commentary highlights features of MHSA conditions and services that affect consideration of reform principles. There are differences in MHSA services availability and financing between private and public sectors. Not all private plans cover all MSHA conditions and services, and MHSA coverage is often less generous than for medical conditions, although such coverage has improved over time.

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