FNP2B1, BSN, MSN, RN, APRN, NP 4,596 Views
I work as a dermatology nurse practitioner and love it! I'm politically conservative, speak with a Southern accent and live in Southern California.
Hmm. I thought I was the only one who did this (although for a slightly different reason). I was jestingly called a loser by a couple friends for this but I'm happy with my FNP choice.
Ooh, i bet that extra $1.50 makes FNP2B1 feel waaay better.
[quote=fnp2b1;6661973][font=helvetica neue]just last week, california medical association filed a petition with cms asking that corrective action be taken to address current reimbursement rates and access standards.[font=helvetica neue] [font=helvetica neue]“what we’re seeing now, is that medi-cal patients are already having a tough time getting access to care,” james t. hay, m.d., cma president said. “with these cuts, physicians will only be reimbursed $11 per medi-cal patient visit, when it costs the physician several times that to provide. physicians will be forced to reduce the number of medi-cal patients they accept, if they can continue to see any at all. we want to be able to treat these patients and we regret that the federal government is making it impossible.”like i said earlier.....just because all of these people now have obamacare doesn't mean anybody is going to treat them. i know i'm not for $9,35 for an office visit. nps get paid 85% of what a md does for an office visit.obamacare alienates providers. [font=helvetica neue]
that's just pathetically criminal.
I think this is a major victory for the country. I of course know it poses many challenges, but the bottom line is, everyone has the right to recieve care. That being said I think it will challenge nurses and doctors alike to do more education, and focus more or prevention.
The health care bill was discussed in Congress over several years and various versions were online for those wanting to keep up with the changes. It wasn't discussed behind closed doors in the dead of night. Click here for the timeline of the Finance Committee's work to reform America's health care system - health care reform from conception to final passage.
1. how many goodies your doctors get
is your doctor prescribing you certain drugs because those are the best for your condition or because of a pharmaceutical company's influence? here's one way you can find out.
the physician payment sunshine act under health care reform requires drug, device or medical supply companies to report annually certain payments or things of value that they've given physicians and teaching hospitals. this could be speaking fees, consulting fees, meals and travel. so, you can find out which and how much companies pay doctors or health care workers. the companies are obligated to report annually about physician ownership and their financial investments.
all this would be available on a public website.
effective date: final rule is expected december 2014.
this is great for the 11 or 12 people who will bother to look up this info. however, guess who is going to pay for whoever is going to compile this information, and who is going to pay for the gov't to make sure the law is followed?
2. more breastfeeding rooms and breaks
many working mothers now get a more appropriate place for expressing breast milk than they had before. employers must provide a place, other than a bathroom, that is shielded from view and free from intrusion from co-workers and the public, which may be used by an employee to express breast milk."
nursing mothers also can take "reasonable breaks" during the workday to express milk, as frequently as the mother needs. the exception is companies with fewer than 50 employees, which can claim it's an undue hardship.
effective date: march 23, 2010.
not a bad thing, but most employers already do this. why do we need to waste gov't resources to regulate it?
the law requires restaurants with 20 or more locations to list calorie content information for standard menu items.
3. caloric reality at every major chain restaurants
under the law, you would walk into a place like mcdonald's and see calories listed under every menu item -- big mac (540 calories), mcnuggets (10 pieces- 470 calories) and medium fries (380 calories).
the law requires restaurants with 20 or more locations to list calorie content information for standard menu items on menus and drive-through menus. other fun facts like fat, saturated fat, cholesterol, sodium, total carbohydrates, sugars, fiber and total protein would have to be made available in writing upon request.
so far, there is mixed evidence about whether calorie postings sway nutritional choices.
the rule also extends to vending machine operators who own or operate 20 or more vending machines. the fda issued a report in april 2011, and left out movie theaters among those establishments required to post calories. so, if implemented, you can tell how many calories your sandwich has at subway, but you won't be able to tell how many calories your buckets of popcorn have at the movie theater.
effective date: the fda has not yet issued a final rule, so there is no time line on its implementation.
an example of the gov't babysitting us. why can't we educate ourselves about what is good/bad for us? why do we need to depend on the gov't? again, i suppose the gov't is using resources to enforce this. couldn't we better use these resources on other things that would give us more bang for the buck, such as health education?
4. abstinence-only education
the health care legislation renews $50 million per year for five years for abstinence-only education. according to the department of health and human services, "programs that receive this funding must teach that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems." and they also have to teach that sex before marriage is "likely to have harmful psychological and physical effects." for every four federal dollars a state receives, it must match $3 (75% of the federal money, in other words).
i would rather that sex ed be taught at home, but i know not always possible. so, not a bad thing here.
5. flexible spending accounts stiffen
flexible spending accounts previously could be used to buy over-the-counter drugs and vitamins. as of 2011, the accounts became restricted to prescription drugs, although in some cases a doctor can "prescribe" over-the-counter medicines to make them count. health care related purchases that still qualify include condoms, contact lens solution, home diagnostic tests and bandages.
but note that in 2013, your contribution amount to these accounts will have an annual limit of $2,500; previously there was no limit.
effective date: january 1, 2011, for the medication provision; january 1, 2013, for the contribution limit.
unless you want to pay more in taxes, i don't see how this is a good thing. please explain. also, doctor's are going to be wasting a lot of their time seeing patients who want a script for a otc.
6. tanning will cost you
you've been paying a 10% tax every time you've visited the tanning booth, thanks to health care reform.
the uv-emitting tanning devices have been classified as "carcinogenic to humans" by the international agency for research on cancer, which is part of the world health organization. indoor tanning has also been banned for minors in california because of the potential for skin cancer.
effective date: july 1, 2010.
why a tax on this and not on hundreds of other things that aren't good for us?
7. support for wellness programs at work
face it, staying healthy in a stressful workplace with the tempting soda machine in the break room can be tough. but the health care reform law gives companies incentives to start wellness initiatives.
small business got incentives in 2011, when companies with fewer than 100 employees working at least 25 hours per week became eligible for wellness program grants. the law sets up a $200 million grant program from 2011 to 2015.
as of 2014, participants in wellness programs generally can get discounts or rewards from their employers of up to 30% of the cost of their health care premiums (currently, the maximum discount is 20%). that reward can go up to 50% if the secretaries of labor, health and human services and the treasury deem it appropriate.
effective date: january 1, 2011, for the small business and january 1, 2014, for the potential discount raise.
employers already have an incentives for wellness programs. happy and healthy employees who show up and are productive, and less $$$ on healthcare costs. again, our tax money would be better spent elsewhere.
8. free preventive care
mammograms, physical exams, colonoscopies, vaccinations -- these are among the preventive care services that will be fully covered by insurance companies.
this requirement kicked in for new health insurance plans that began on or after september 2010. examples of preventive care include screenings for cholesterol, diabetes, hiv and sexually transmitted diseases, which are covered without a co-pay.
for women, this would also cover genetic counseling for the brca gene for women at higher risk of breast cancer, mammograms every one or two years for women over age 40 and hpv dna testing every three years for women. for kids, the services include autism, vision, developmental and lead screenings. the complete list is available here.
effective date: all health insurance plans must comply by 2018.
as someone else mentioned, nothing is free.
9. home visits to expecting families
the law also includes funding support for early childhood home visitation for people expecting children and families who have young children. professionals come to the home to provide information and support. the aim is to reduce child abuse and neglect, promote the health of mothers and their children and prioritize high-risk populations. research supports such positive outcomes. the health care law provides $1.5 billion for related state-based initiatives over five years.
effective date: began in 2010 with $100 million for fiscal year.
not a terrible thing, but aren't their charities a local gov'ts who already do such a thing? when we are broke as a country, maybe this isn't necessary.
10. health plans you can read
have you ever been confused by the language in health insurance plans?
the health reform law requires health insurers and health plans to provide concise and understandable information about the plan and its benefits. according to the health and human services press release, "the new rules will also make it easier for people and employers to directly compare one plan to another."
patients have a right to two key documents to understand and compare their health insurance choices: a comprehensible summary of benefits (which is standardized similar to nutrition facts on packaged foods) and a glossary of terms of health insurance coverage.
effective date: september 23, 2012.
The above link talks about new taxes on those of us who make less than $250K....you know, the ones who were promised not a dime more.
but note that in 2013, your contribution amount to these accounts will have an annual limit of $2,500; previously there was no limit.
15$ seems very very low. My co-payment is 15$ to see my primary MD. I don't see why there aren't any co-payments for Medi-cal and Medi-care. There should be. If they could afford a cell-phone bill, how can they not afford forking $15 for co-payment. Doesn't make sense. Also the same with ER visits. Again I can't imagine 15$ reimbursement.
What can go wrong is providers like me will quit seeing all Medicaid patients. I work in California. If I have a patient who is straight Med-Cal which is Medicaid for California I get paid $15 for the visit. I, along with the other providers I work with have severely limited the amount of straight Medicaid patients we see. If reimbursement falls lower we will quit seeing those patients all together.
If Obamacare doesn't get repealed and the reductions in payments to Medicare providers goes through I will quit seeing Medicare patients. My entire office has sent letters to our patients letting them know they will have to find another provider if reimbursement gets lowered. We will stick with cash paying and PPO patients.
More importantly, the people of Massachussetts wanted it and they got it. In contrast, the law we have now was signed while disregarding the People's wishes.
Oh, really? You critics of this health care act certainly do not speak for me. A few years back, when my oldest child graduated from high school going on to college, I remember waking up in the middle of the night thinking how this adult child was going to afford college and health insurance without my and my husband’s help (which we could then not continue him on our family plan.) And then my second one also graduated from high school without health insurance. Any decent parents would be thinking about this.
Now, all of our children can stay in our insurance coverage until they are 26 years old. I am happy for those who can take advantage of this.
However, I often find myself wondering, where were you, Obamacare when I needed you?
Do the research. It isnt a secret or something made up.
I am shaking my head at the news that poll after poll show americans want higher taxes! Astounded, really. Must be the 49% who pay no income taxes at all. And whose business is to assume that those who can afford a cadillac plan can also afford to pay more. That irritates me.
Good synopsis. I really hate the part of punishing people who can afford fhe best plans. It serves no purpose. It is the Affordable Act...if they can adford it, why penalize them for that with higher taxes?
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