Burnam M A, Escarce J J
Drug Policy Research Center, RAND, Santa Monica, California, USA.
Health Aff (Millwood). 1999 Sep-Oct;18(5):22-31. doi: 10.1377/hlthaff.18.5.22.
Equity of mental health care relative to general medical care is a long-standing policy issue in the mental health field, which in recent years has been debated as an issue of parity in insurance benefits. The shift toward managed mental health care makes the parity debate less controversial, because feared cost increases are an unlikely consequence under managed care. We argue, however, that managed care also makes benefit parity less relevant to the goals of achieving fairness in the delivery of mental health services. A broader policy perspective is required to encompass concerns about fairness under managed care.
相对于普通医疗保健而言，精神卫生保健的公平性是精神卫生领域长期存在的政策问题，近年来一直作为保险福利平等问题进行辩论。向管理式精神卫生保健的转变使平等辩论的争议性降低，因为在管理式医疗保健下不太可能出现人们所担心的成本增加情况。然而，我们认为，管理式医疗保健也使福利平等与实现精神卫生服务公平提供的目标关联度降低。需要从更广泛的政策视角来考量管理式医疗保健下的公平问题。
