Costs of Change, Political Polarization, and Re-Election Hurdles

We develop and study a two-period model of political competition with office- and policymotivated candidates, in which (i) changes of policies impose costs on all individuals and (ii) such costs increase with the magnitude of the policy change. We show that there is an optimal positive level of costs of change that minimizes policy polarization and maximizes welfare. One interpretation of this finding is that societies with intermediate levels of conservatism achieve the highest welfare and the lowest polarization levels. We apply our model to the design of optimal re-election hurdles. In particular, we show that raising the vote-share needed for re-election above 50% weakly reduces policy polarization and tends to increase welfare. Furthermore, we identify circumstances where the optimal re-election hurdle is strictly larger than 50%

Toward a Rational Model of Depression Treatment

Depression is a heterogeneous condition with significant variations in both course and response to treatment. The diverse needs of depressed individuals suggest that treatment should be organized systematically, with multiple efficacious treatment modalities such as psychotherapy and pharmacotherapy available and delivered in a manner and sequence consistent with the best available evidence. Moreover, these systems must be cost-conscious, implementable in regular practice, and accessible to those who require treatment. We term such structures “rational” systems of care. In this chapter, we provide a review of essential components of a rational system, including (1) identifying individuals in need of services, (2) selecting treatment(s), (3) monitoring response and supporting clinical decisions, (4) adapting treatment strategies, (5) maintaining the treatment response, and (6) maximizing access. Case examples of national efforts to implement systems of depression care are provided and discussed, followed by a review of implementation and research issues

Toward a Rational Model of Depression Treatment

Depression is a heterogeneous condition with significant variations in both course and response to treatment. The diverse needs of depressed individuals suggest that treatment should be organized systematically, with multiple efficacious treatment modalities such as psychotherapy and pharmacotherapy available and delivered in a manner and sequence consistent with the best available evidence. Moreover, these systems must be cost-conscious, implementable in regular practice, and accessible to those who require treatment. We term such structures “rational” systems of care. In this chapter, we provide a review of essential components of a rational system, including (1) identifying individuals in need of services, (2) selecting treatment(s), (3) monitoring response and supporting clinical decisions, (4) adapting treatment strategies, (5) maintaining the treatment response, and (6) maximizing access. Case examples of national efforts to implement systems of depression care are provided and discussed, followed by a review of implementation and research issues