Moody's promotes Obamacare

Today it was reported that Moody's Investors Service supports "Obamacare", the Patient Protection and Affordable Care Act, because it provides a greater income base for non-profit hospitals. They are not as happy about reductions in Medicare payments for physicians, also included in the law.


I have been casually following the progress of this law and public challenges it faces with several thoughts in mind.

1. It is a good thing for all persons to have insurance. The more people have insurance the more costs can be spread and, at least theoretically, that should lower retail healthcare. I say that knowing that prices always go up, never down. I am reminded of the premiums paid for organic foods.
2. In North Carolina, mental healthcare reform led to increased rationing and increased overhead due to increased "accountability" to enforce fraud laws and to use recoupments  to balance the budget. This created a very dicey environment for providers and additional layers of administration that were funded with lower reimbursements for services.
3. Reduced services (not access, it is a policy goal to increase access) has led to increased importance of the crisis and intake assessments in promoting good behavioral health and "recovery engagement". This is not the system I was trained for in graduate school; true for most providers, surely.
4. While the politicians wrangle over power and donations business (especially insurance carriers and hospitals) is adapting to the new model(s).

So, what does the changing system mean for crisis services?

Good question. One worth spending some time with. If crisis services continues to be where the money is spent, clearly training and technology must adapt.