This issue of the Archives reports data from six studies dealing with the economics of psychiatric practice and the costs of illness. These data are presented in an economic climate in which restraints of medical care expenditures and rationing are everywhere evident. The high costs of care are at times depicted as resulting from an excessive use of technology; from expenditures wasted upon the dying; from the greed of hospitals and physicians; or from perverse fiscal incentives that have us treat illness and not promote health. At times, it almost seems as if there is no disease, but only institutions, systems, and providers that need better organization and regulation. The desire to cut expenditures has even extended to biomedical research activities that continue to provide our best opportunity to reduce costs through the search for knowledge and cure.
Within this context, the funding and structure of care are already substantially
Astrachan BM. Costs of Practice, Barriers to Psychiatric Service, and Research ExpendituresFailures of Policy. Arch Gen Psychiatry. 1985;42(6):625-626. doi:10.1001/archpsyc.1985.01790290107012