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More logical reforms at health policy aim towards addressing broader threats to health and healthcare as a society, rather than on an individual level (Mechanic 52-54). Additionally, efforts towards preventative care could help reform health policy, as both of these changes in the United State's view on healthcare would be much more progressive. The major challenge that affects reform appears to be long-held ideas and feelings towards the way that healthcare has been managed in the past, and the inability of citizen's and policy makers to stray from such thoughts. Mental health is probably the most misunderstood aspect of health care, mostly because it too is bogged down by a history of misconceptions and improper solutions to mental health issues. This is largely due to people's perceptions of mental health, and also insurance companies lack of eagerness to provide payment for mental health treatments. It should be noted, as well, that a large portion of the mentally ill end up unnoticed for most of their life, and end up homeless or in correctional facilities. The Diagnostic and Statistical Manual of Mental Disorders (DSM) holds hundreds of classifications of mental illnesses. Because classification can be difficult, it is also difficult to classify such disorders for insurance purposes. Greater parity (equal payment for mental as well as health) in terms of insurance is also needed as a whole (Mechanic 77-80). In general, mental health still remains largely overlooked in terms of health care in the United States. Medicare was an early attempt to reform much of the problems in health care for United States citizens. In the mid-1900's, as the system and views of healthcare changed, mainly as costs grew out of control, more and more Americans were unable to pay for health care; mainly the poor and the elderly.

In 2004, according to the Robert Wood Johnson Foundation, "through 2014, an estimated $200 billion will be spent on new hospital construction across the U.S." and the U.S. Census Bureau reported, "spending on private health care construction (hospitals, medical buildings, and specialty care) increased 65% from 2000 to 2006," (Holton, 2007). According to a 2005 survey of twelve U.S. sites, there are four main categories of hospital construction: new full-service hospitals or substantial expansion of existing general hospital capacity; new facilities or expansion of existing capacity for specific specialty services; total or partial replacement of old facilities; expansion of particular service areas for which patient demand typically exceeds the available supply of services, (Holton, 2007). . .

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