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.

Mapping the Landscape: a Rationale to blog about Emergency Behavioral Health

Welcome to my latest blogging project. This blog will present my ideas about behavioral health crisis response as they develop. In the past I've used blogs to post news item and resources and to collect interesting items for presentation elsewhere; but not this time. Now I am collecting my thoughts after 13+ years of professional crisis response in preparation for a return to graduate school and the leap into the next phase of my career.

The field of emergency behavioral health is broad, making it very easy to get lost without a map. In this blog I will try to create such a map, a visualization or picture, of where the on the web the informational cities are located and what areas are ripe for development. The more I collect and organize my professional library the clearer the vision from the summit of the "big questions".

Over the years blogging has matured tremendously; my style and knowledge of blogging hasn't exactly kept up. To catch up I've surfed a little--according to Urban Dictionary "surf the web" is still a relevant phrase--and read that good writing is the key to getting and keeping readers. Marketing is how readers find what has been written.

So now I'm starting to lose focus from the topic/purpose of this post--staying focused is one of my "growing edges"--and getting caught playing with the language and not the idea. Cleanly stated: The purpose of this post is to talk a little about the challenges of maintaining a blog and what I hope to accomplish with this project.

I will have a job that allows me to travel (and collect commemorative stamp images like those issued through the Eastern National (EN) passport program and sought by the members of the National Park Travelers Club (NPTC)) and assist communities to serve their most vulnerable. All while living in serenity. Its a tall order. But, its time to direct my energies with my talents. For many years I've guided my career and personal choices with the mission "to give back to the community that gave so much to me" as I've adapted to compromise. Now I will take the hard steps to create my future. [time for a quick breather. that statement sets up so many challenges, I mean, opportunities.]

The most vulnerable include those who have used up all their resources to cope with life's challenges. A strong safety net is required for persons and families experiencing a behavioral health crisis or psychiatric emergency to return to normal functioning with as little disruption as necessary. This is the topic I will explore with this blog.

What have I accomplished tonight?

• defined my topic
• created a rationale post
• outlined my professional goal(s)
• reminded myself about the difficulty of practicing humility

What is left to accomplish?

•  outlining a structure for my posts
• linking to some guideline websites

1. Keep posts <250 words. (source)
2. Have interesting headlines. (source)
3. Use relevant keywords consistently and naturally to promote search engine optimization (SEO) and relevance for readers (should also force greater focus on topic organization). (source)

Lessons from previous blogging experiences:

1. post regularly with valuable content
2. this blog is not just a linkdump or collection of items. It is my job, as blogger, to connect the dots and show why the item is relevant.

Part structural guide, part lofty goal announcement, part focus statement: this post covers a lot of ground--and breaks most of the style guidelines just presented.... Thoughtful practice is important to increasing the subtly of our skills; reflection is required for thoughtful practice. Hopefully I can accomplish what this blog sets out to do...The Moon or Bust!