ABSTRACT
INTRODUCTION In many respects the public sector has always “managed” popula tions of patients under fixed budgets. The vagaries of state and/or federal funding have traditionally influenced the extent to which pub lic systems could meet mental health needs. Ethical dilemmas about financing and allocation of resources under public sector managed care (PSMC) have been experienced for decades. Nevertheless, the broad range and diversity of PSMC initiatives with varying models of delivery, cost consciousness, and profit motives have created new sets of ethical dilemmas and intensified others. This chapter will fo cus on how the current ethical dilemmas may manifest themselves and how we might deal effectively with them.
