Abstract
Even before the election of President Clinton, it was widely believed that some form of a national health plan (NHP) would be enacted by Congress during the next presidential term.1 Indeed, health care insurance reform plans are emerging at a dizzying rate. The pressing public policy issues include control of health care costs; equity in access to health care services; and in mental health, parity between insurance coverage for psychiatric disorders and other medical illnesses. As a nation we currently spend 14% of our Gross National Product on health care, and yet, at some point during a single year, nearly 40 million people have no health insurance. Of those who are insured, few have adequate coverage for major mental illness. This column will not discuss the many (more than 50) different proposals for an NHP but rather will focus on the following question: What are the major concerns for psychiatry under any national health insurance reform?
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