Abstract
Health and mental health care in America have come under increasing scrutiny during the last half of the 20th century from a vast array of stakeholders, including consumers, providers, employers, community leaders, policymakers, administrators, educators, as well as lawmakers at the state and federal levels of government. Proposals for national and state health care reform have been prompted, in part, by the need to control the rising costs of health care and to address the obstacles and inequities in accessing health and mental health services. Although the United States Congress did not pass major comprehensive health care reform legislation in the 1990s, significant health care initiatives (particularly in association with entitlement programs) have been proposed and implemented by various individual states.
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