An RN's thoughts on the health care law - page 4
I've been following the debate about the health care law and it seems like most commenters are totally for it or adamantly against it. I've been watching my family, friends, and patients face bad... Read More
2Jul 8, '12 by lamazeteacher"That Guy" has the same reaction that many doctors have to coverage for everyone. It's commonly known as the "I've got mine" approach to the needs of others.
The way this remarkable act (remarkable for having passed both houses, despite strenuous opposition) works to lower medical costs, is that those who will be covered, will no longer use the ED as their neighborhood doctors' office, arriving in more advanced states of their illnesses. That costs us taxpayers more, and provides fewer other programs (like transportation) that could benefit us. Prevention programs also will keep almost everyone well enough to work, longer than the current programs.
Since doctors charge so much for their services, utilization of nurses for patient education and nurse practitioners for preliminary care will increase, and that means more time will be spent with patients by professionals who have expertise to educate them more thoroughly and effectively. Doctors traditionally speak to patients with terminology that is difficult for them to understand, and in a dispassionate manner that forbids emotional reactions (no time for that).
Consequently, remuneration for nurses will likely increase, as well as job opportunities.Last edit by lamazeteacher on Jul 8, '12
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5Jul 8, '12 by One1Quote from lamazeteacherLamazeteacher, I am not sure that this will play out as everybody hopes. I come from one of those countries that has socialized healthcare, and one of the big problems is that 1)it is common to NOT be able to see your PCP the same day (or the next, for that matter) and that 2)further testing requiring specialists/special equipment will not be as readily/quickly available as it is in the ED (CT scans, MRIs, scopes, etc). With the immediate availability of care plus all these convenient tests in the ED and the American sense of customer entitlement (expectation to receive service immediately), I believe that many patients will continue to come to the ED rather than seek out their PCP, even for "non-emergent" complaints.those who will be covered, will no longer use the ED as their neighborhood doctors' office, arriving in more advanced states of their illnesses.
2Jul 9, '12 by NayRNQuote from qdiva411Yes, they take takes out of your paycheck. Then, in February, they give them back in the form of a tax return. Hence, no taxes paid. Income taxes at least.Please don't generalize the "55%" that don't pay taxes. No one knows every story. I haven't worked in 2 years because I'm a single mother and I was in college through a program that assists us in getting our degree. (Family Scholar House, look it up). I am now a registerd nurse working at a large hospital in my community. Im pursuing a BSN (which the hospital is helping pay for) and I pay taxes AND have health insurance now. Bam! Out of the 55%! Of course there will be loopholes. Like any other system (welfare for example, which im saying goodbye to) there is the potential for abuse. I think there are other ways to fix some of these issues. I am choosing to keep an open mind and although I an a nurse, my second passion is the fight to end poverty. A fight that will aid in bringing our country back to where we want it. The more people we can get into the professional world, the lesser the strain on our money, yes? We're not all "dead-beats." Excuse me while I dive off my soapbox! =)
2Jul 9, '12 by lamazeteacherI'm reading a lot of unfounded, fear driven speculation here, which has no basis in fact! It is obvious that many posts are based on hearsay, rather than authoritative sources. The original poster (OP) went to a lot of effort to get facts here. Please be sure you do that, too
before getting off on unfounded rants about paying for others' healthcare and increased taxes, and specialists being paid the same rates as less advanced physicians. That's hype fostered by insurance
companies!They have a vested
interest in being the only healthcare
payers, and not only is that not
working, bigtime, it provides those
who are high up in management of
those insurance companies, with
outrageously high compensation
(think Wall Street).It is still going to
be the employers who provide
insurance for their employees who
work more than 20 hours/ week.
If you currently have insurance,
nothing will change now, or in 2014. However, many fewer
employees will find themselves
unemployed due to much higher
insurance premiums because of
their age or preexisting
As an Employee Health Nurse 8
years ago, my job was clearly to
feret out those employees for whom
insurance costs would render them
too expensive to have benefits, and
report them to administration. Also if employees used injuries sustained at work, their performance and possible future overuse/abuse of workers' compensation was suspect, as was their work.
The locked files that I was supposed to reassure employees, were "private" were available to the VP of
the organization and in fact resided
right outside his office! According to ACA, now employees fired by companies that find insurance costs to keep a particular employee are
too high, that will violate the law. Also, terminated employees as well as everyone else can get healthcare
through affordable government
programs without taxes being levied others to pay for that!
Read the law (certainly not as difficult or illegible to non lawyers as some would have you believe, and Republicans' alternate proposal is) and you'll know that, don't just
adopt the opinion of someone else
who hasn't read it!
Free clinics will remain necessary
for those immigrants who are
undocumented, and those who
refuse to buy their own insurance.
A post here indicated that doctors who staff those clinics receive pay, yet the vital premise of such services is that professionals donate
their services. I've volunteered my nursing services to several Free clinics, and know doctors where I was, weren't paid.
Just after my graduation as a Public Health Nurse in Canada (where I spent my first 22 years), I worked where the doctors who initiated Ontario's healthcare program were. It wasn't opposed by the people (although other provinces had protests) and politicians had little to do with it being started. My family is still there, and they enjoy no financial worries due to ill health and are seen the same day they call for an appointment, if necessary. My 83 year old sister just had spinal fusion surgery with great results, there. She did have to wait 3 months to have the surgery, after making her decision to have it (following decades of addiction to prescribed narcotics - her choice). She is now narcotic
free! When visiting Canada, I ask friends and family if they resent "their" tax dollars going to healthcare for others. The response is always, "Why should I?" Doctors there are not compensated as lavishly as American physicians, and they live in large homes with domestic help, and drive reasonably luxurious cars. When attending medical conferences in the USA, they do salivate over conversations with our overpaid physicians. They appreciate that it is their passion for providing healthcare that is what drives them to provide excellence in services, not dreams of wealth.Last edit by lamazeteacher on Jul 9, '12 : Reason: additions, spacing
4Jul 9, '12 by CountyRatThank you, lamazeteacher , for reminding us of the importance of knowing the facts before we opine. That is good advice, which is why I thought that you would like to know that most major insurance companies supported the Affordable Care Act because insuring more people will broaden their customer base.
I would be grateful to you if you could provide the facts on which you base your statement that, "Also, terminated employees as well as everyone else can get healthcare through affordable government programs without taxes being levied others to pay for that!" I am eager to know how the government can operate programs without levying taxes. My understanding has been that everything the government does is funded by taxation. Please let me know what the government's other source of money is.
Wishing you the best and looking forward to your reply,
David Deitsch, RN
2Jul 9, '12 by MunoRNQuote from CountyRatI think you're confusing salary with profit. You don't actually make a "profit" you make a salary which is what provides you with "more money than (you) need to survive". Employees at non-profit companies still earn a salary.Thank you for taking the time to publish this thoughtful summary and commentary. You raise many important points, but one that stands out in my mind is your apparent distaste for profit. Do you offer your talents and services at no charge, or do you require that those who benefit from them compensate you?
I work to make a profit (i.e., to make more money than I need to survive) so that I can also save, invest, buy luxury items, and enjoy other pleasures over and above what I need to survive. I do not apologize for this, nor do I ask thers to apologize, whether they are individual employees like myself, or a members of a groups of people joining together to form a corporation.
David Detsch, RN
Profit motive can be a good thing, although it can also be destructive. The problem with the way the health insurance industry is set up is that the profit motive encourages worse, not better, service.
Insurance companies function essentially as a bookkeeper. Imagine you had an accountant who's job was to keep your books, deposit your paychecks, and pay your bills. Imagine if this accountant decided they could add to their profit by keeping the mortgage payment for themselves rather than paying the mortgage, not caring that you'll lose your house, that's your problem. I find it hard to believe that would be acceptable, but it happens all the time in the health care insurance industry.
1Jul 10, '12 by herring_RN Guidenj woman with rapidly swelling 51-pound cancer tumor forced to delay treatment for insurance
surgeons have successfully removed a rapidly ballooning 51-pound cancerous tumor from a woman who was forced to delay treatment for more than a month until she become eligible for health insurance. ...
nj woman with rapidly swelling 51-pound cancer tumor forced to delay treatment for insurance - medical daily
3Jul 10, '12 by tntrnQuote from lamazeteacherThat is simply not so. If you have health care now, you are at risk of your employer opting to not cover you any more. So you will have to find other insurance. Of course, the President promised us all that we could keep our doctor, keep our insurance, keep our coverage. What he failed to say is that his promise was only good if our doctor, if our employer, if our insurance chose to stay the same.....which they don't have to do, and many won't do.
If you currently have insurance,
nothing will change now, or in 2014.
3Jul 10, '12 by lamazeteacherThis illustrates how hopeless things appear to uninsured persons, and how that costs lives!If the current healthcare delivery "system" served everyone well, by 64 years of age we would have known that there are government programs that might have been used by the
patient described here.However the
path to be included in them, is
littered with pitfalls, the first of
which is that it is not possible now,
to get efficient action quickly.
Government workers are rewarded
for being thorough, not polite or
providing a respectful attitude.Lines
of applicants form outside the
"eligibility" office at least an hour before offices open, in communities with low cost housing, and after getting a number (no one is there
to direct them to do that, so there is a rush to the counter, which makes employees there quite anxious. So when they do point to signs that indicate where the numbers are, across the waiting area from the entrance, everyone is unhappy already.
The state funding for offices and
personnel, actually increases costs
because they are seedy looking and
the atmosphere is grim. That
doesn't bode well for bringing
people back to complete the
process. Screaming children run
around and there is palpable
despair among the applicants. Add
to that a uniformed, menacing yet
bored looking guard seated a few
feet from the front door, in the
middle of the chaos, whose
knowledge of his job is only to be
there and if a physical disruption
occurs, deal with it by calling the
police and threaten participants
until help arrives. No social worker
or crisis intervention worker is part
of the staffing, and the workers
there are ill equipped to deal with
people like this patient whose needs are immediate.There is no alternative if they don't go to an ER at a facility that has social workers (where are they, these days?).
It's much easier, without having a crystal ball that gives some idea of what will happen in situations such as the one reported to do nothing.
There was embarrassment and fear this lady must have experienced as her increased abdominal girth
became more and more apparent,
(implying irresponsible eating or
pregnancy...) It would take a very well informed, positively motivated person to pass through the
gauntlets this woman faced, for her
to get earlier healthcare. It's human
nature to choose the easiest path, which for her meant waiting until her birthday to get the needed
Medicare coverage, and denial
added to her tendency to put off
facing such a painful, unpleasant
As she found out, it takes time for
the promise to become reality. The
longer government agencies take to
process bewildering forms, more cases stack up for their agency to handle.
Once the Affordable Healthcare Act is up and running smoothly
(without the next administration
canceling it), there won't be the
timelines of coverage based on
employment, and gaps that we
now experience. Please give that a chance and sponsor an attitude that good coverage for healthcare is
about to happen! We have to
anticipate that there will be wrinkles to work out, attitudes to improve, and communication for consumers to know they can either continue to
have the healthcare they've had
before or get the temporary
government coverage until they
No one wants to anticipate illness,
so often informative pamphlets get
the round file treatment before
they're read, or they stay where
they were placed.
The financial industry has more effective ways of getting their
message heard. They find the
consumer groups with common interests such as seniors and give them a free meal as they learn how their money can be invested to go further in retirement.
Healthcare has many groups that
can be tapped for common
denominators, such as young adults for whom pregnancy needs to be
planned; and those who are already expecting their babies and need
preparation for financial hurdles,
as well as labor and parenting classes.
People need to know what their
priorities for saving money are!
Their education for that, needs to
start in High School. Think of the
information families can get
(especially newly arrived ones
whose language is other than
English, who already learn about life
where they live, from their school
aged children) through having the
information their children will be
given. That also enhances learning
and interfamilial relationships, and
needs to be encouraged by
healthcare providers.Those who
project ill will can jeopardize the wellbeing of others, and continue hopelessness, or they can take the leap necessary to support the Affordable Healthcare through it's most fragile stage at the beginning, and smile when describing how patients will get the care they need.
Who knows, positive approaches and smiles will continue past that and signal the ability to have a good outcome. That will promote earlier care and diminish fear for the long haul!Last edit by lamazeteacher on Jul 10, '12 : Reason: completeness
0Jul 12, '12 by lamazeteacherThe newspapers ran an article yesterday about this. I'll find it and post it here, or in Facebook (as Lois Feldstein-Klein).Last edit by lamazeteacher on Jul 12, '12 : Reason: typo corrected
2Jul 19, '12 by herring_RN Guidemedicare beneficiaries less likely to experience cost- and access-related problems than adults with private coverage
[color=#333333]medicare beneficiaries age 65 and older are more satisfied with their health insurance, have better access to care, and are less likely to have problems paying medical bills than working-age adults who get insurance through employers or purchase coverage on their own. ...
[color=#333333]medicare beneficiaries less likely to experience cost- and access-related problems than adults with private coverage - the commonwealth fund
1Jul 22, '12 by herring_RN Guide[color=#111111]how i lost my fear of universal health care
permission to live: how i lost my fear of universal health care
1Jul 24, '12 by SC_RNDude, BSN, RNQuote from herring_rni am a little skeptical when the first thing the author tells us is how she was a "die-hard conservative republican", and then describes how she is anything but one and even provides links to a die-hard liberal website. she even explains how she is now ok with gov't providing abortions. maybe her political leanings have changed. that's fine, it happens. i also love the gobs of anecdotal evidence. so, i'm more inclined to believe she has always been a liberal who believes in universal healthcare, and is embellishing her story for effect.[color=#111111]how i lost my fear of universal health care
permission to live: how i lost my fear of universal health care
that being said, there are fixes needed for our healthcare system. however, there are much better ways of doing it then universal healthcare. frankly, i don't believe she should not have to "worry about exepense" and should receive 55% of her salary for a year because she chose to have a baby (or 2, or 4) while everyone else pays for her decision.