Mental Health Care and National Health Insurance: A Philosophy of and an Approach to Mental Health Care for the Future

The burial societies of the Romans were, essentially, private group insurance programs. So were the protection funds of medieval guilds. Largely through the efforts of labor unions, by 1968 more than two-thirds of the labor force in U.S. industry was covered by group life and health insurance plans mostly provided (as fringe benefits) by employers. Today the proportion is even higher, and the establishment of national health insurance, to be sponsored by government, is being debated in the halls of Congress. Complete medical care for the citizenry, with health professionals partly or wholly salaried by a government agency, is now standard in many coun­ tries, including those of eastern Europe, most of the British commonwealth (including Australia, Canada, and New Zealand), several Latin American countries, Greece, Turkey, Sweden, and of course China, the USSR, and eastern Europe. The major alternative scheme, in which the government provides reimbursement for private care, is employed by several other West­ ern nations, including Norway, Denmark, Austria, West Germany, and Spain. Both of these methods of government coverage exist for certain groups in the United States: the former for military personnel, service-connected or impecunious veterans, and the indigent mentally ill; the latter for those cov­ ered under the 1965 amendment to the Social Security Act. However, most health insurance in the United States is private, much of it operating on a group basis.