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Welfare Reform on the Web (March 2007): Mental health services - overseas

Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes

D.P. Doessel and others

Health Economics, Policy and Law, vol. 2, 2007, p.7-22

Australia has a national, compulsory and universal health insurance called Medicare. The system involves a mixture of publicly provided hospital services free at the point of use and subsidised privately produced medical services provided on a fee-for-service basis. In order to reign in expenditure on private psychiatric services, in 1996 the government announced a change in the insurance reimbursement of some consultations with psychiatrists. This involved a 50% reduction in the rebate provided after a consumer had received 50 consultations per year, irrespective of psychiatrist. At the same time, the government introduced at new Item (319) into the Medicare Benefit Schedule Book to cover some special cases adversely affected by the first policy change and a “fee-freeze” for all medical services. This article seeks to disentangle the effects of these three policy initiatives.

Medicaid policy changes in mental health care and their effect on mental health outcomes

A.E. Cuellar and S. Markowitz

Health Economics, Policy and Law, vol. 2, 2007, p. 23-49

In recent years Medicaid has seen a dramatic increase in spending on psychotropic drugs. This article examines the influence of Medicaid spending on these drugs on the mental health of enrollees as measured by rates of suicide, criminal offences and arrests, and fatal unintentional injuries. Results show that increased spending on some antidepressants positively influences suicide rates in adults and that expansion of stimulant provision has encouraging results in reducing violent crime.

Political equality and the disenfranchisement of people with intellectual impairments

L. Beckman

Social Policy and Society, vol. 6, 2007, p. 13-23

In most democratic countries people with learning difficulties or mental health problems are denied the right to vote in national elections. One reason for this is that they are perceived as incapable of making independent political judgements and may therefore fail to vote on the basis of their own preferences. Their exclusion is consequently defended by an appeal to the need to protect the integrity of democratic elections. In this article, this assertion is critically examined.

Trends in residential policies and services for people with intellectual disabilities in Taiwan

Y.C. Chou and R.L. Schalock

Journal of Intellectual Disability Research, vol.51, 2007, p.135-141

In Taiwan, 92-95% of people with an intellectual disability live with their families, while the remainder live in residential homes. Residential facilities for people with an intellectual disability were expanded in the 1990s. Many of these residential institutions are large in Western terms, the average unit size being 66 beds in 2005. Thus in Taiwan, unlike in Western countries, residential homes for people with an intellectual disability are growing in number. The option of independent living in the community is not available.

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