ABSTRACT
Health and mental health care in the United States have come under increasing scrutiny during the last half of the 20th century from a vast array of stakeholders, including patients, providers, employers, administrators, and researchers, as well as policymakers in state and federal government. Proposals for health care (including managed health care) reform have been prompted, in part, by the need to control the rising costs of health and mental health care and to address the obstacles and inequities in accessing health and mental health services. Although the U.S. Congress did not pass major comprehensive health care reform legislation in the final decade of the 20th century, significant health care initiatives (e.g., in managed care and in association with entitlement programs) were proposed and implemented by various individual states.
