Most health systems have been closing behavioral medicine beds for years. The patients that fill beds in the facilities that still exist are usually on Medicaid or unfunded. It’s tough to breakeven on that type of payer mix. As noted, states have closed the state owned facilities, but the void created wasn’t filled by privately owned systems because of the poor economics. In some states, the number of providers willing to work on the in-patient side of behavioral medicine is also an issue. Most providers want to have a commercial insurance out-patient practice. The issue is especially acute in states that didn’t expand Medicaid, further degrading the payer mix. Outside academic medicine (and academics is a small percentage of healthcare infrastructure overall), our approach to behavioal medicine is failing. I will offer the disclaimer that my experience is in the rust belt and Deep South, so it might be skewed.Agree on the Top 3 issue comment. It surely is.
You may be right on the tax dollar thing. Hopefully the money could be reallocated (I'm sure some wags, not me, might suggest the Police or Defense budgets).
The "For Profit," high-priced Private mental health rehab places around the country are not gonna take care of guys with profiles like these shooters. When mental health hospitals proliferated throughout the USA, they were invariably State-run institutions (aka "snake pits"), and formed a vast bureaucracy at a high cost. That was the main reason so many closed; taxpayers decided they no longer wanted to foot that bill.
Just curious… when u don’t get canned responses, is it in regards to something that goes against their agenda?Sorry to hear that
Guess I've been very lucky.
On occasion I've gotten a few canned responses but for the most part I've gotten responses specifically addressing whatever my letter brought up and my concerns. I always keep it clear, respectful, factual and without hyperbole.
Whenever I've gotten what was obviously a canned response I've still pushed on.
First of all, I accept the fact that my opinion WILL NOT ALWAYS prevail. I realize that they can't be at my beck and call and I also realize many of the responses I've received were written by staffers. But it's important to me that they are aware of my viewpoints and that they know I'm not alone in how I feel.
Believe it or not, your letters do have an impact. As most in Congress and their staff do keep track of how their constituents are responding to events . Some might not care due to partisanship, but that's the voters fault
I'm not ready to give up on our system of government. It's up to the citizenery to make it work.
I feel for you guys because if I ever reach the point that I've actually made every effort to be heard and yet feel as if I have absolutely no voice on how I'm governed...then really it's time to leave.
Years before I was in healthcare, I worked in downtown WPB. One day there was a man who stood on the corner screaming obscenities arguing at a car stopped at the light. He was screaming, "How dare you call me (the n word). I'll beat your *** if you say that again, so go ahead, *****!." In the car was a white guy in his late 50's wearing a shirt and tie and more than a little bit nervous waiting for the light to change. The cop escorting us to the parking lot just asked him to calm down. He said the guy was a regar and usually ran out of meds before the end of the month and the health dept would give him more until the 1st, so it was a rough couple of days for him.Most health systems have been closing behavioral medicine beds for years. The patients that fill beds in the facilities that still exist are usually on Medicaid or unfunded. It’s tough to breakeven on that type of payer mix. As noted, states have closed the state owned facilities, but the void created wasn’t filled by privately owned systems because of the poor economics. In some states, the number of providers willing to work on the in-patient side of behavioral medicine is also an issue. Most providers want to have a commercial insurance out-patient practice. The issue is especially acute in states that didn’t expand Medicaid, further degrading the payer mix. Outside academic medicine (and academics is a small percentage of healthcare infrastructure overall), our approach to behavioal medicine is failing. I will offer the disclaimer that my experience is in the rust belt and Deep South, so it might be skewed.
The current economics in healthcare may cause another wave of bed closures, as systems are really taking a beating. I am interested where folks think the funds could come from without raising taxes to improve the safety net.
Just curious… when u don’t get canned responses, is it in regards to something that goes against their agenda?
There are decent congress people out there (unfortunately not the two senators from NY)… but it depends on if u are lucky enough to have them represent u
I don’t believe there is anymore money in state/federal healthcare to do it. I meant out of state and federal budgets. There is more waste than ever. There’s a lot of good things that could be getting done, that aren’t.Most health systems have been closing behavioral medicine beds for years. The patients that fill beds in the facilities that still exist are usually on Medicaid or unfunded. It’s tough to breakeven on that type of payer mix. As noted, states have closed the state owned facilities, but the void created wasn’t filled by privately owned systems because of the poor economics. In some states, the number of providers willing to work on the in-patient side of behavioral medicine is also an issue. Most providers want to have a commercial insurance out-patient practice. The issue is especially acute in states that didn’t expand Medicaid, further degrading the payer mix. Outside academic medicine (and academics is a small percentage of healthcare infrastructure overall), our approach to behavioal medicine is failing. I will offer the disclaimer that my experience is in the rust belt and Deep South, so it might be skewed.
The current economics in healthcare may cause another wave of bed closures, as systems are really taking a beating. I am interested where folks think the funds could come from without raising taxes to improve the safety net.
I have tried to engage in medicaid reform conversations with various folks at the state level. The insurance companies that states subcontract their Medicaid programs to prevent meaningful reform.I don’t believe there is anymore money in state/federal healthcare to do it. I meant out of state and federal budgets. There is more waste than ever. There’s a lot of good things that could be getting done, that aren’t.
I get that I am talking about taking wasteful spending from other programs outside of healthcare and putting them into facilities.I have tried to engage in medicaid reform conversations with various folks at the state level. The insurance companies that states subcontract their Medicaid programs to prevent meaningful reform.
It's most likely going to get struck down by the Supreme Court in the next session, but NY just passed a new gun law and part of the background check is to require people to give their social media accounts so they can be checked "to confirm the information regarding the applicant’s character and conduct"!
New York bill could mandate social media checks for gun permit applications
The checks would be part of a process to verify the applicant’s "character and conduct."www.axios.com
I’m obviously a huge 2A advocate, but I’m also very aware of the mental health crisis we have. Which is why we need to open up more hospitals and if you say you want to kill yourself or other, you get admitted. Period. He was another prime candidate
My dad is a veteran and respectfully the VA Hospital hasn’t been the care I would want. My dad doesn’t love it, but he does use it. I agree there is often a wide gap between ideal and actual care.Years before I was in healthcare, I worked in downtown WPB. One day there was a man who stood on the corner screaming obscenities arguing at a car stopped at the light. He was screaming, "How dare you call me (the n word). I'll beat your *** if you say that again, so go ahead, *****!." In the car was a white guy in his late 50's wearing a shirt and tie and more than a little bit nervous waiting for the light to change. The cop escorting us to the parking lot just asked him to calm down. He said the guy was a regar and usually ran out of meds before the end of the month and the health dept would give him more until the 1st, so it was a rough couple of days for him.
The was before ACAand Medicare expansion, but it goes to show the system doesn't actually care about helping people, just going through the motions.
Oh how sad.My dad is a veteran and respectfully the VA Hospital hasn’t been the care I would want. My dad doesn’t love it, but he does use it. I agree there is often a wide gap between ideal and actual care.
It's a damning argument against single payer.My dad is a veteran and respectfully the VA Hospital hasn’t been the care I would want. My dad doesn’t love it, but he does use it. I agree there is often a wide gap between ideal and actual care.
Something a lot of people don't realize is they changed the rules for how drugs are approved at the FDA. Companies now contribute to the cost, meaning they're allowed to fund the studies. They contributed over $800 million last year. Money has tainted the decision process. They suppressed repurposing existing drugs, which we've done for years, and ignored acquired immunity when setting guidelines. As of now, the vaccines are under emergency use authorization, EUA. If they get officially approved, then they can be held liable to side-effects/injury from the vaccines. There's a reason they're pushing so hard for vaccinating children, even though the virus is little more than a cold for them, except in rare cases. The vaccine data for children is very bad, basically placebo, but if they get the vaccines approved for children, that will make them immune to liability for vaccine injury.Nobody will go after Big Pharma. They’re too powerful and fund too many politicians. They’re bulletproof , even though they‘re a big portion of the problem.
It was a clap back law… Supreme Court, u are gonna kill one of our bills… well, we’ll just make another unconstitutional one! Take that!That’s certainly a very poorly planned law destined to fail. We need to do something meaningful. That law is not it, respectfully. I didn’t think I’d say do nothing, but nothing vs that proposed law I’ll take nothing.
I have no idea about individual state laws outside of mine. But red flag laws will never help. NY is trying to make it where you have to show your social media profile to get a firearm. While that may sound harmless, it’s not. Asking the political party in charge of your state to decide who can and can’t get a firearm is the dumbest idea there is. And don’t for one second think whoever is in charge of making that decision is apolitical.This is something I have no answer for, but think it’s been touched on.
Suicidal ideation and terroristic threats are the biggie and in my line of work will get you 1013d. I can’t seem to get any concept though of how long they might have to wait to get a firearm?
I am suggesting for our discussion that exhibit A is 22 now. He had been bullied in middle school. Tried to kill himself in the 8th grade. Outside of those years in middle school, exhibit A has been to therapy and takes meds or smokes medical marijuana. In Georgia it specifically says no marijuana on the application process for background check I believe.
Just for the discussion please see medical marijuana as therapy not just a stoner that wants a gun.
To me this candidate would be fine for a gun. But **** who the **** really knows? What do you think?
PS. Imagine being a therapist or doctor, are you signing off for someone to buy a gun?
I suppose I can get squirrelly and see the worst happening. I don’t like the eroding of rights. I know you don’t either. Respectfully even though we differ on Roe v Wade, I absolutely think it’s an erosion of rights. I suppose the Supreme Court said it isn’t a right. With enough rewriting of law and precedence rejection, I think anything any of us hold dear can be taken away.
It was a clap back law… Supreme Court, u are gonna kill one of our bills… well, we’ll just make another unconstitutional one! Take that!