Editor's comment: Special section on mental health care financing

Abstract

Health care and mental health care financing in this country seem to be reaching a crisis point. Millions of people in this country no longer have basic health care coverage. The federal government continues to inject stop-gap mechanisms, but never seems to face the problem head-on. One interesting experiment turned the nation's eyes toward Oregon's innovative funding plan for health care: ~the Oregon basic health care act of 1989." This plan is an attempt to make basic health care available to the entire population by using a system of formulas to determine which procedures could be funded and which couldn't be afforded. The plan will give the state the responsibility to fund health care for all those whose income falls below the federal poverty level, while all others will be covered by either a subsidized or mandated employer health plan, or by private individual health insurance. No one is to go without basic coverage. What is even more unusual about this plan is that all the major psychiatric diagnostic categories in DSM III-R are included. Nevertheless, at the date of this writing, the Oregon plan has not yet been approved by the federal government, and there is no national plan. Because this crisis in funding seems so prominent to us (perhaps because we here have spent so much energy trying to solve it), we decided to create a special section in this month's issue of Community Mental Health Journal devoted entirely to financing mechanisms for mental health care systems. We have provided three points of view, each of which contains a variety of perspectives, examples, and opinions on how to solve this agonizing problem. Most sophisticated, civilized, Western democracies have already figured this out. Maybe some time we Americans can as well.