Content That FNP2B1 Likes

Content That FNP2B1 Likes

FNP2B1, BSN, MSN, RN, APRN, NP 4,729 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.

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  • Mar 24

    Quote from Goldenfox
    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.
    Nope I finished school worked for 4 years, $80,000 in debt and not working as a CRNA for several reasons..mainly due to stress. Wish I would have went a different route i.e. NP

  • Jul 1 '12

    Ooh, i bet that extra $1.50 makes FNP2B1 feel waaay better.

  • Jul 1 '12

    [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.

  • Jul 1 '12

    Quote from MorganB
    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.
    Everyone has a right to healthcare? What does this mean? Everyone does already have access to healthcare to some extent, so I presume you meant to say "free and unlimited healthcare". I have heard the "everyone has a right to healthcare" line before by the President, his liberal friends, and others like yourself, but no one has explained specifically what this means or how it's going to work.

    So, you want to see a physician. You want to see one now. That is your right. You want to use the doctor's services. If it's your right, then no one can deny you, no one can say no. How about surgery?. You want a surgery, nevermind if you truly need one or not, you want one so if it is your right so no one can deny you the surgery. How about your oxycodone prescription. It's for your health, so it is your right. No one can say "no, you can't have the oxycodone." It's your right to have this product that someone else produced.

    You are going to go to the hospital. You are going to use the hospital, it's physicians, nurses, techs, scanners, operating rooms, food, housekeepers, medication, etc. They can't say no. It's your right to go and consume these things and use their services. They say it's time for you to go. Oh no they don't! It's your right to be there.

    I know there are several of you "healthcare is a right" people here. Someone, please explain what this means, how it's going to work, and where exactly does this "right" come from!

  • Jul 1 '12

    Quote from mediajunkie650
    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.
    Ideas were discussed for many years, but the the bill that was signed by the President in March of 2010 was published online for the first time in November 2009 and had been passed by congress by Christmas. Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

    And, there were many omissions and additions of the bill in between, (first bill in November had 2000 pages, bill passed in December had 2400) many at the last minute, and many that were the result of "closed door" deals. Payoffs for states get Harry Reid to 60 votes - Chris Frates - POLITICO.com

  • Jul 1 '12

    Quote from simonemyheart
    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.
    they already do this. seems pretty subjective anyway. they should start with a healthcare law that everyone can read and understand.



  • Jul 1 '12

    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.

  • Jul 1 '12

    but note that in 2013, your contribution amount to these accounts will have an annual limit of $2,500; previously there was no limit.
    absolutely ridiculous! because my 2 children have chronic conditions, our co-pays and deductibles only cover so much. last year we spent over $7,000 in additional medical costs. now i can't have my flex dollars cover those?!

    *****

    also, the one major problem the op did not address is the fact that the new act requires hospitals to cut back a great deal more on spending. where do you think those cuts are going to come from?

    [color=#333333]"for-profit hospital chains like hca are big enough to reduce costs and change their practices across the board to emphasize quality in ways smaller companies can't do. for nonprofit hospitals, health care reform looks to be a real challenge. although more patients with health insurance means fewer people receiving medical care without paying their bills, medicare payment cuts and pressure from private health insurance companies to keep rates down will squeeze their revenue."
    according to moody's.

  • Jul 1 '12

    Quote from jojonavy
    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.
    Or hair extensions, high end Handbags (even from outlets), perfect nails. There is no reason to doubt the $15 reimbursement..which only underscores the concern of lessening them.

  • Jul 1 '12

    Quote from FNP2B1
    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.
    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.

  • Jul 1 '12

    Quote from notpuurfctbtgdenghns
    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?
    Yes, really. Most Americans are not in favor of the law in it's current form, and were not when it passed.

    They are your kids! Why shouldn't you help them afford college and insurance?

    If there was more competition allowed between insurance companies, many companies on their own would probably let children stay on their parents policy awhile longer. As it is I was allowed to stay on my parents policy while I was in college, and my stepson is on mine now at age 21. Instead, we have the government telling insurance companies how to run their business.

    There are some good things about the law, but law as a whole is going to bring us all down if we don't elect a new president, throw this law out, and start over.

  • Jul 1 '12
  • Jul 1 '12

    Do the research. It isnt a secret or something made up.

  • Jul 1 '12

    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.

  • Jul 1 '12

    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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