Health affairs
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This study reviews Medicaid policies to restrict access to psychiatric medications. Policies on prior authorization, preferred drug lists, limitations on the number of prescriptions, fail-first requirements, and use of generics are reviewed. All states apply one or more of those policies to medications for mental illness, and many apply several. ⋯ Other psychiatric medications are less well protected. Some states appear to restrict access severely. Questions have been raised as to whether these policies actually save money in the long term.
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Medical school tuition and medical student debt have increased dramatically during the past two decades, but loans are available on favorable terms, which makes it possible for students without personal or family means to get a medical education. As an investment, medical education is an excellent choice; its net present value is more than a million dollars. Cost is nevertheless a strong deterrent to potential applicants, especially minority applicants. If tuition and indebtedness continue to increase while physician incomes do not, there may come a time when only the wealthy can finance a medical education, and medical schools may have increasing difficulty recruiting qualified students.