Can someone "dumb down" what Obamacare really means? - page 4
by EarthwormRN | 22,411 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
- 5Aug 15, '12 by GrnTea, BSN, MSN, RNThis is what you want. The first video is made by that noted radical group, Kaiser Health Care. It's an animated video narrated by Cokie Roberts. It is designed to be clear, understandable and nonpartisan. Note that it was made before the law was passed, so some of the verb tenses will be off.
Next is the explanation by Medscape of the ten titles in the ACA, the Affordable Care Act. It was prepared for Medscape by John McDonough, DPh MPA, a noted health policy researcher and analyst from Harvard School of Public Health.
The ACA -- What’s Really In It?
Medscape: Medscape Access
Title I. Quality, Affordable Health Care for All Americans
This title fundamentally changes the nature and operation of private health insurance in the United States. Beginning in 2014, no health insurer will be able to sell or rate coverage based on an individual''s medical history; most Americans will be required to obtain health insurance; and substantial financial subsidies will be available to low- and moderate-income Americans to help them afford the cost of health insurance. Most states will operate new "health insurance exchanges" to make shopping for health insurance easier. Small businesses and individuals can shop these insurance exchanges for competitive rates. Other important changes in health insurance, including the banning of lifetime and annual benefit limits, were implemented in 2010.
Title II. The Role of Public Programs
This title creates substantial changes to Medicaid, the federal-state program for many low-income persons. Beginning in 2014, all lower-income individuals will be eligible to enroll in their state's Medicaid program, not just those who fit into categories such as disabled, children, or parents. For the first time, Medicaid will become a more uniform national program with uniform eligibility and enrollment standards as well as quality improvement requirements.
Title III. Improving the Quality and Efficiency of Health Care
This title establishes new mechanisms to improve the quality of medical care in the United States by making it more efficient and effective, and more patient-centered. Medicare will be improved with the addition of new preventive benefits for enrollees; and the Medicare Part D drug benefit will be made more affordable by closing the coverage gap known as the "donut hole." Medicare's rate of growth will be lowered to provide about $450 billion in savings between 2010 and 2019, which should fund about half the cost of the ACA.
Title IV. Prevention of Chronic Disease and the Improvement of Public Health
Title IV is the most ambitious law ever passed to promote healthier lifestyles for all Americans and to prevent disease and disability. A National Prevention, Health Promotion, and Public Health Council will devise a national prevention strategy, backed up by a $13 billion Trust Fund. Evidence-based clinical preventive services will be provided in most public and private health insurance policies without cost-sharing. Chain restaurants will be required to post the calorie content of their foods.
Title V. Healthcare Workforce
This title establishes a National Healthcare Workforce Commission to analyze and plan for workforce needs and to make recommendations to congress and the administration. Support is provided to expand the healthcare workforce, especially in primary care. Major expansions for community health centers and the National Health Service Corps are funded.
Title VI. Transparency and Program Integrity
Title VI provides new authority to federal and state agencies to combat fraud and abuse in Medicare, Medicaid, and private health insurance. Drug companies and medical suppliers will report most gifts and other gratuities to physicians for public release on a federal Website. The Patient Centered Outcomes Research Institute is established as a public-private entity to support research on comparative clinical effectiveness. New transparency requirements on the nursing home industry will provide information to protect and empower patients and their families. The Elder Justice Act provides a national framework to combat violence, neglect, and financial exploitation of senior citizens.
Title VII. Improving Access to Innovative Medical Therapies
This title directs the US Food and Drug Administration to develop a regulatory pathway to permit the development, manufacture, marketing, and sale of biosimilar biologic products, generic-like versions of biopharmaceutical drugs. It also ends anticompetitive efforts to keep generic drugs off the market, and offers drug discounts to hospitals and communities that serve low-income patients.
Title VIII. CLASS: Community Living Assistance Supports and Services
This title authorizes a new national and voluntary long-term disability insurance program to provide workers with daily cash payments and support if they become permanently and temporarily disabled. People who enroll in CLASS must pay premiums for a minimum of 5 years. The funding is flexible and can be used for a range of services. No tax money will be used to fund this program. Its only permitted financing source -- enrollee premiums -- must be sufficient for at least 75 years if the Health and Human Services Secretary is to launch the program.
Editor's Note: The Obama administration announced on October 15 that it was abandoning plans for CLASS. Congress is expected to quickly draft legislation to repeal the provisions of this title.
Title IX. Revenue Provisions
This section covers the financing for slightly less than half the cost of the ACA. Key provisions establish new Medicare taxes on high-income wage earners, as well as new taxes on pharmaceutical manufacturers, health insurance providers, and medical device manufacturers. Also included is an excise tax on high-cost, employer-provided health insurance; changes to health savings accounts and other individual health accounts; and a 10% tax on indoor tanning services.
Title X. Strengthening Quality, Affordable Healthcare for All Americans
The final title in the act is the "Manager's Amendment," which includes amendments and additions to Titles I-IX, reflecting the unusual legislative process leading to passage of the ACA. Additional changes to Titles I-X were approved in a separate measure called the Health Care and Education Reconciliation Act (HCERA) signed into law by President Obama 1 week after he signed the base law on March 23, 2010. This title also reauthorizes the Indian Health Care Improvement Act, which provides healthcare to American Indians and Alaskan natives.
John E. McDonough, DPh, MPA
Professor of Health Policy and Management
Harvard University School of Public Health
John E. McDonough, DPh, MPA, has disclosed no relevant financial relationships.Last edit by GrnTea on Aug 15, '12
- 2Aug 15, '12 by TRichterHI.
There are a lot of opinions here. The Accountable Care Act is trying to make medical care available for everyone, regardless of age or pre-existing conditions. As it stands, many people who have chronic illnesses cannot afford the insurance to help them recieve much needed treatment to prevent them from having to visit ER, and admissions.
Currently, Medicare has chosen large organizations and hospitals as Accountable Care Organizations. Their role is to try to "manage" and control cost for medicare patients who have straight medicare, which allows them to see any specialist any time they choose. Accountable Care Organizations (ACO) need to find ways to educate these patients on managing their care better and on their illnesses, allowing patients to manage their health much better than they are currently. IN so doing this, the thought is it will lower costs of care for these patients because they will learn how to stay healthy, and how to limit the tests and procedures they have. THis program is in it's infancy stage, so the ACOs are still trying to figure out the best way to help the Medicare patients. If they do figure it out, and lower the yearly costs spent on Health Care for these patients, this could "bench mark" new standards of care for all patients.
In no part of the ACA is there any stipulations on limiting care patients receive. It is limiting unnecessary items, or repeating things unnecessarily. I have friends who live in England, and their health care is in no way limited. They recieve great care, they just pay higher taxes. So instead of higher taxes, which AMerican's have voted against, the government has found a way to make insurance affordable for everyone.
I believe it is a win/win situation if we all work together. From what I understand, the only way Health Care providers, nurses and such will be directly effected would be in salary. We need to think about why we entered into this line of work.
- 2Aug 15, '12 by cdsgaI got in this profession to care for people clinically-and to make enough money to provide for my family and myself. I did not get into this profession to drain myself, sacrifice my life and my livelihood to provide care to the masses. I don't make a lot of money, but enough to be able to provide basic needs. I am not a nun-I am not working for charity.
With the ever present expectation to get higher education, more money is required, more sacrifice is required, and there should be some way to compensate those who try to meet the basic requirements. There are many other ways to cut cost-in fact studies have shown time and again that it's the nurses who save the facilities money.
I don't appreciate the idea that this ACA can't sustain compensating experienced nurses and novice nurses by paying wages for nurses for years of experience, degrees earned, certifications, continuing education, travel. They want more NP's-they want more PhD's, well then make it affordable-with some return on the investment. When these higher degree nurses have their credentials, you can rest assured they will not be at the bedside. They've earned the right not to be there. It's the trenches where we need good experienced people to take care of the sicker and sicker patients-insured or not.
We have endured years where no raises were given, shortages-no relief in site (I remember the 80's), having to stay overtime while you had to arrange for childcare etc in your absence because you had to attend to sick people. We all have lives, not everyone lives in a big city, and no one should be burdened with guilt that you make a wage compensatory to your line of work. Lawyers and Doctors certainly don't. Insurance agents certainly don't. Why do we always have to have the guilt trip laid on us?
If the only way we will be directly effected is by salary-then you will see lots of nurses leave the profession-leaving a formidable shortage and novice nurses who have no idea what to do, how to cope and many who do not share the same level of duty as the old nurses have demonstrated.
It's going to be interesting.
- 3Aug 15, '12 by FuzzyAll I know about is that for the first time in my adult life (except when I was on disability) I've had affordable health insurance. This is the same plan that covers Federal employees. I tried going the private route. I was either turned down or the premiums were more then my paycheck. I am not offered health insurance through my workplace.
What this does for me is make preventative care affordable.
Keeps me from going bankrupt should I become seriously ill.
Gives me some peace of mind.
For more information go to PCIP - Pre-existing Condition Insurance Plan - Home
Right now I love Obamacare.
- 0Aug 15, '12 by SC_RNDudeQuote from joshscSo, those who have a different opinion then yours must be making up facts for have politicial motives? How disheartening that you believe that.Completely AMAZING how even among medical professionals, that instead of being professional and giving the true facts, it becomes political. How disheartening and shameful.