Can someone "dumb down" what Obamacare really means? - page 3

by EarthwormRN

21,251 Views | 138 Comments

I don't have time to watch the news or read articles so I don't understand much of what is being talked about. Can someone explain to me how it changes for citizens and what it will do to the future of our healthcare system?... Read More


  1. 6
    Well since socialized healthcare sucks, it's a good thing that the Affordable Care Act is absolutely NOT socialized healthcare.
    Not_A_Hat_Person, Sisyphus, Elinor, and 3 others like this.
  2. 2
    Ok, if thats the little wonder bubble you want to live in, be my guest. I just hope you guys dont end up having to live with the consequences of this 'not socialized' healthcare
    amgladwell12 and tntrn like this.
  3. 5
    Fascinating, please continue..
  4. 12
    Quote from Jeweles26
    Ok, if thats the little wonder bubble you want to live in, be my guest. I just hope you guys dont end up having to live with the consequences of this 'not socialized' healthcare
    I'm also from Canada, And I also live in Michigan with my fiancÚ. Politics and bulls*** aside I've had four surgeries in Canada in the past 1 1/2 years with top of the line health care, no wait. "Socialized" or not, our government takes care of us, but there is a downside to every system, it's certainly not black and white. I don't like to get involved in politics, mostly because It tends to end up as a ******* match.

    I also had to do PT in the US in order to keep my student visa active, that bill was $15,000 for 2 1/2 months(115/15 mins) not including every other fee on the face of the earth. I am currently doing PT in Canada (crossing the border for every visit) where it currently costs $53 flat rate for 45 mins. I don't see anything wrong with bringing inflation down to a reasonable rate where people don't end up bankrupt. My PT is also beginning to advertise over the border to bring uninsured residents to their facility.....

    I don't know what the answer is for the US..but ya gotta try right?
  5. 0
    Touche!! MBA
  6. 1
    But see thats the point I made on an earlier post. If you compare the 45% income tax to the 20% or so I am looking at here, that 25% difference that comes out of your paycheck certainly makes up the difference. In fact, it comes out to around the cost of pretty high end insurance in the US. Or at least it did for how much *I* was paying...
    Sensibility likes this.
  7. 0
    Quote from EarthwormRN
    I don't have time to watch the news or read articles so I don't understand much of what is being talked about. Can someone explain to me how it changes for citizens and what it will do to the future of our healthcare system? Particularly, for us nurses.
    The ACA is a major overhaul of the healthcare industry. EMRs are required by 10/2014. The need for nurse coders and informatics is going to increase dramatically. At the very least you will need to have Epic, Cerner, Meditech or Eclypsis experience on your resume.

    We can expect to see a huge influx of patients in all settings.

    Reimbursements will decrease and I think we will have to do even more with less staff. Older expensive nurses are going to suffer even more and be replaced by cheaper inexperienced new grads. The National Nurses Union is going to really expand and become a force like the NEA.

    Meaningful use standards in health care will be strictly enforced with heavy fines from the OIG.

    The system of incentives and taxes on hospital profits may force some hospitals to close their doors.

    There are many of well researched articles on NYtimes.com.
  8. 1
    Pay for performance does not work. Just look at the education system-funds for schools who test well-leads to fraud and manipulation of scores to make sure that the stats are straight and the funds are awarded. Same thing will happen to healthcare. Check boxes for regulatory processes being completed on paper. Just to not get payments dropped from Medicare.

    I don't think anyone person will do away with Medicare-not unless they want a mass revolution.

    I do think socialized medicine sounds good, but in reality it's not. Lets put everything in one pot so everyone can benefit. The people who work hard get the same thing as those who don't????

    What are we saying? Healthcare should be a charity? If that were the case then all nurses should be housed, fed and clothed waiving their salary-which you top out at 15 years of service in the current world. Look at where the profits are going-insurance companies. More and more doctors are giving up their offices and working for hospital run medical management groups-which lowers their overhead and makes them an employee rather than a business owner. That has pluses and minuses.

    My personal opinion should be better ways of accessing insurance-across state lines. Shop for the benefits you want-form networks like groups that will decrease the amount of premiums.

    I don't think the veterans get the best care. VA's are staffed by residents and interns. The nursing care is good. Medical care??? not so sure. I've seen and heard of bad outcomes---remember the issue with HIV and hepatitis from dirty scopes???? That was VA-it took the attention of many to upgrade Walter Reed-not too long ago that hospital was not in the best shape. Thank God for the injured vets from the recent wars-the technology and rehab facilities have been upgraded and are becoming top-notch. But it took exposing the hospital for that to happen.

    I think the way of the future is a Mayo Clinic or John's Hopkins type situation. But these are mostly specialty institutions and send the patients back to their primary physicians who have to follow the treatment plans and follow up. How do they cope? They don't get the grants and money through donations that a Mayo type institution does.

    I also think it is imperative to limit the buffet of equipment that hospitals purchase-rentals should be the way to go-especially since technology is changing so fast and by the time you buy something it becomes obsolete.

    If this Affordable Care Act is to work and all mandates are met-then cutting nursing staff is not an option. Cut something else, limit amount of money spent on superfluous things (marketing/signage/advertising)-and increase the staffing to ensure that these mandates are met-word of mouth and positive patient outcomes speak more volumes than expensive TV/Radio/Print ads. By spending some money on salaries, hospitals and other healthcare facilities can ensure that the payments will come. It's hard to be perfect and meet the goals when understaffed and overworked, not to mention all the pressure when measures cannot be attained due to powers outside the nurses' ability.
    bstullis likes this.
  9. 0
    Quote from EarthwormRN
    I don't have time to watch the news or read articles so I don't understand much of what is being talked about. Can someone explain to me how it changes for citizens and what it will do to the future of our healthcare system? Particularly, for us nurses.

    I don't have time either, and there are so many comments that contradict, that I don't know what is right or wrong.

    However, the hospital that I currently work at is a non-profit Catholic hospital and it has been sold to a for-profit healthcare conglomerate that happens to own the only other hospital in our area. The 2 hospitals will be combined and made smaller and leaner. The rummer mill says there will be substantial lay-offs and the 2 hospitals merge. We have 280 beds, the other hospital has 160 and when it is all over, there will be about 280 beds. Mgmt sends out an email every week that says "oh no!. Layoffs will never happen!" We have a nurse/patient ratio of 5/1 or 6/1. The company that has purchased us uses a 7/1.

    We were very hurt and shocked that we were sold. We were told that with Obama care, there will be NO WAY for both hospitals to survive in that climate due to cuts in revenue payments for services and that for both hospitals to make it, they have to combine and be more efficient; use resources in the best way possible.

    It will be interesting as we move forward. There will be layoffs and there are not many places for the nurses that get laid off to go here. Many will have to move. Me included.
  10. 11
    The ACA (too often called "Obamacare" as if he could pass legislation all by himself) is not a perfect bill, but is the result of compromise, as is all legislation that gets passed in this country. Members of Congress USED to have the same choices in health insurance plans as did all of the federal civil service employees in this country. Because of the uproar about them not being eligible for coverage under the "health insurance exchanges" (because, like all of the civil service employees they had access to excellent coverage through their "employer"), they passed a provision that requires them to get coverage via a "health care exchange" when that part of the law goes into effect. The ACA also includes provisions (some of which are going into effect now) to support education of more nurse practitioners to increase the supply of primary care providers in many communities. Two goals of the bill are to get more people to seek preventive treatment and to seek early treatment for illnesses thus preventing more serious illnesses needing more expensive treatment. Hopefully, it will reduce overall expenditures for ERs and ICUs treating people who waited too long to seek care because they couldn't afford the bills. I imagine that more hospitals will establish "urgent care centers" semi-attached to their ERs where people with non-emergent problems can be sent for care, reducing the load on the ERs AND decreasing the perceived advantages of using the ER instead of seeing one's primary care provider during regular office hours.

    The bill is intended to make healthcare insurance affordable -- and to strongly encourage even the "young, healthy adults" who think they won't need it to get it anyway. Since young, healthy adults sometimes get injured (while not in a vehicle or on the job) and sick (appendicitis, etc.), they can be a drain on the system if uninsured. Since hospitals that get Medicare or Medicaid payments or any kind of federal funding are forbidden to turn away from their ERs any patient with an emergent condition, a LOT of people are GETTING care and the rest of us are paying for it through higher insurance premiums and taxes. Just as states TRY to assure that everyone who drives a car has at least liability insurance in case they damage another's property with that car, the federal government is TRYING to get every adult and family to contribute at least a little toward paying for health care that almost everyone will eventually need.

    Again, the bill is FAR from perfect, but after decades of discussion (since Harry Truman was president) something is being done. Like every other law of major proportions in our history, some tweaking and some major adjustments will be necessary. But, if you've been involved in healthcare for very long (I'm now over 4 decades as a nurse) you've seen a LOT of patients who needed healthcare and knew it but didn't want "charity" so delayed until they were forced to seek care due to disability. If we can reduce that drain on our economy and society, I'm convinced it would be a good thing.

    Finally, Fact Check (from the Annenberg Public Policy Center from the University of Pennsylvania provides a good attempt at "apolitical" doses of information on Public Policy and political advertisements. Here is a link to its pages on the ACA where they provide a "dumbed down" version of the information about the bill as well as links to sections of the bill for those who want to read the exact wording in the bill: FactCheck.org : Search Results

    Give that a try to get specific questions answered.


Top