An Analysis of Capitation for Mental Health Services

The major impetus for health care reform clearly seems to be the desire to contain the cost of health care. One of the major cost-containment methods proposed is capitation. Capitation poses specific problems when applied to mental health services delivery. This article discusses several of the major issues pertaining to the utility of capitation in mental health, discusses on-going capitation efforts, and provides an evaluation of capitation programs. Future directions for research on capitation in mental health are then suggested.     

Fearing Food: The Influence of Risk Perceptions on Public Preferences for Uniform and Centralized Risk Regulation

Public opinion features prominently in policy research because it sets bounds on the definition of policy problems and acceptable policy solutions. We contend that public opinion is also important for setting bounds on the level of government at which policy hazards are regulated by shaping preferences for uniformity of regulation and, relatedly, preferences for centralization. We offer a theoretical argument for why risk creates pressures for uniform standards and examine the extent to which preferences for uniformity and centralization are the product of fairly stable individual-level predispositions (e.g. partisanship and ideology) versus more fluid attitudes like perceptions of risk, which vary in response to crises, new information, and issue framing. We test our argument using survey data in the policy domain of food safety and find that individuals who anticipate greater risk from food-borne illness prefer more uniform food safety regulation, which translates into preferences for federal-level policymaking. Our results imply that contextual circumstances and strategic communications that influence risk perceptions can create not only generalized public demand for more regulatory policy but specific demand for uniform, centralized regulation.