This comprehensive, in-depth overview  uses a biopsychosocial perspective  to look at health and mental health care policy in the U.S.   It looks at the legislative and political development of health and mental health care policy,  focuses on the failure to achieve universal coverage, and examines the development of employment-based insurance and managed care. The authors discuss the impact of poverty and inequality on health, examine the health status of disadvantaged and at-risk populations, and consider implications for policy and practice.

Table of Contents:
Part ONE  Introduction       1 of Health and Health Policy   Introduction   Determinants of Health: A Biopsychosocial Perspective   Biological Factors   Psychological Factors   Social Factors  Biopsychosocial Dynamics  A Biopsychosocial Approach to Health    Approaches to Health Policy   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                The Beginnings of Social Work and Public Health    The Need for Public Health Services   The Mental Hygiene Movement   Compulsory Health Insurance Efforts: 1912—1920    American Association for Labor Legislation    Establishment of the U.S. Public Health Service    Federal—State Reforms and Private Insurance: 1920—1932    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    Maternal and Child Health Services    The Failure to Enact Compulsory Insurance    Federal Health and Mental Health Policy and Services: 1941—1946    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   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    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    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  State Comprehensive Mental Health Services Plan Act   Stewart B. McKinney Homeless Assistance Act   The Rise and Fall of the Health Security Act: 1988—1996   Proposals for a Single-Payer Plan   Clinton’s Proposal: The Health Security Act of 1993    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    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  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           Quality of Health Care in the United States   Highlights   References    Part THREE  The U.S. Health Care System Today    4    Access to Care   The Need for Access  What Is Access?   Why Is Access Important?   Trends in Coverage and Reasons for Concern   Health Insurance Coverage in the United States   Declining Coverage   Rising Costs    Jobs without Coverage   Changing Work Force   Reductions in Coverage    The Uninsured Population in the United States    Uninsured Workers   Regional and State Differences   Age    Race and Ethnicity    Latinas/os African Americans  Asian Americans    Native Hawaiians and Pacific Islanders    Native Americans Health Insurance and Utilization of Services    Differences in Access among the Insured and Uninsured   Use Patterns by People of Color    U.S. Indian Health Service    Community Benefits: The Free-Care Safety Net    Improving Access to Health Care    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   Medicare 1 Choice    Medicare Advantage Managed Care and Medicaid    Balanced Budget Act of 1997    State Medicaid Managed-Care Plans    Managed Behavioral Health Care    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    Benefits and Financing   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    Older Adults   Adults with Disabilities    Women Managed Care and Medicare    Future of Medicare  Medicaid   Benefits and Financing   Mandatory and Optional Benefits    Mandatory and Optional Eligibility    Medicaid Benefit Payments    Recipients    Poor and Low-Income Pregnant Women, Children, and Families   State Children’s Health Insurance Program (S-CHIP)    Personal Responsibility and Work Opportunity Reconciliation Act of 1996   Poor and Low-Income Children and Adults with Disabilities 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   Demography    Morbidity    Mortality    Life Expectancy    Epidemiology    Health Targets  African Americans    Life Expectancy and Infant Mortality    HIV/AIDS   Cancer and Cardiovascular Disease   Cancer    Cardiovascular Disease    Diabetes   Unintentional Injuries: Neighborhood Violence   Latinas/os (Hispanics)   Life Expectancy and Infant Mortality   Diabetes   HIV/AIDS Asian Americans and Pacific Islanders   Life Expectancy    Cancer and Cardiovascular Disease    Diabetes Native Americans   Chronic Diseases and Infant Mortality    Alcoholism and Alcohol-Related Mental Health Problems Environmental Health Risks   Cancer   Racial Differences in the Delivery of Medical Care    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  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    Infectious Diseases    Risky Behaviors: Substance Abuse  Youth Smoking    Youth Drinking    Youth Drug Abuse    Child Abuse and Neglect    Exposure to Violence    Older Adults    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?  Inequality and Health   Absolute versus Relative Poverty    Inequality and Mortality    Explaining the Health Gradient    Psychosocial Variables Social Cohesion    Childhood Development   Material Conditions    Conclusion Implications for Change Highlights   References   Glossary   Index