Public health care perspectives for the 1990s: What are the options?

Abstract

Despite the high quality of the American health care system at its best, effective service delivery and particularly the integration of substance abuse treatment, mental health services, HIV/AIDS services, and primary care is a serious and continuing problem. The Primary Care/Substance Abuse Linkage Initiative is the central focus of a major Federal effort to improve the integration of health care services. The planning for this initiative is described as are several classes of major barriers to achieving its objectives. These include: (1) issues of health care reimbursement, (2) problems of professional and public attitudes toward alcohol and drug dependency and its treatment, (3) substance abuse treatment service deficiencies, and (4) cultural insensitivity in the planning, administration, and delivery of services to ethnic and racial minorities. A Secretarial Conference and future plans for translating the concept of integrated treatment into a nationwide treatment reality are outlined.