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the conference was held in january 1992, at the end of the tobacco settlement, as part of a series of events coordinated by the robert wood johnson foundation. a major issue at the conference was whether the settlement would be a good or bad thing, both for the nation and for mental health. while most of the conference participants were supportive of the settlement, many voiced concern that it would not work well for the mentally ill. they feared that not all services would be made available, especially those that would be appropriate for consumers of mental health services. many also expressed concern that the money would not be distributed in a fair and equitable way. some participants were cautiously optimistic that some services would be improved as a result of the settlement, but they felt that community planning for such services was poor. throughout the conference and post-conference period, the robert wood johnson foundation convened representatives of the settlement stakeholders and professionals from the mental health sector who could help understand the settlement and to help determine the effects of the settlement on mental health care. the evaluation of the conference discussed in this article is part of this undertaking. the research project was conducted by the department of health, education, and welfare’s health care financing administration and the robert wood johnson foundation.

the psychology services in health care project sought to develop a definition of mental health services that would be accepted by consumer-protection groups, by mental health professionals, and by federal policy makers. the definition was intended to be part of the public policy discussion for the health care financing administration’s new mental health services and supports program, which covers both community-based and institutional mental health services. it was also intended to serve as the foundation for further discussion about consumer-protection issues and the development of mental health service standards. the project studied the existing mental health services that are provided to consumers with mental illness and those that are provided to help the mentally ill who are being treated in other kinds of settings. in addition, the project explored the major issues that are raised when the mentally ill take their own health care into their own hands.

the project included a study of the needs of consumers, and a review of services for the mentally ill that were provided by mental health professionals; a review of both independent and interdependent practitioners, of mental health service providers in general, and of mental health treatment systems; and the development of a description of the actual services and goals of consumers, and an analysis of mental health services generally.
similarly, morelli provided some warning for those who might use the term “single-payer” in talking about medicare for all. a little history of the term will provide some context, she said, and some other policies — like affordable care act, h.r. 676, and the physicians’ patient protection act — have related in interesting ways.
health care would be a great [fiscal] problem to have [sic]: robert] wood johnson health policy center president mark pauly penned a foreword to the conference. he served as a medicare trustee and then a senior adviser to the medicare and medicaid administration. in his opening remarks pauly talked about the need for a principled and honest debate about the nation’s health care delivery system and of its financial malaise, and he encouraged participants to have confidence in the legislation. the conference also offered an introduction to the medicare and medicaid programs. the conference followed a successful 1989 medicare & medicaid partnership summit organized by the robert wood johnson foundation.11
he described medicare as a provider of services, as well as a payer of services. a nearly 500-page blueprint for the nation’s health care system, the sustainable health care act, prescribes a system of health coverage in which the federal government would pay for health care services in exchange for protection of the federal guarantee, an elimination of insurance company profits, and a restructuring of the payment system.
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