Can someone "dumb down" what Obamacare really means? - page 7

by EarthwormRN 21,909 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. 0
    Quote from SC_RNDude
    What is VRBO?
    VRBO is what my mac autocorrected IPAB to (I'm surprised it didn't correct to IPAD). My bad.

    Quote from SC_RNDude
    And, I did slow down and mention that the bill states that care rationing of care isn't supposed to happen. Who is going to make sure they don't? It also states a whole bunch of other nice things they are supposed to do, many of which we already have MedPac for. The White House blog does do a nice job though of making it sound so good!

    This new board does not have any oversite that a "committee" or a policy administor would have. They are creating the policy. And, not just policy, they are creating law in a unprecednted and unconstitutional manner.

    They have one job, to reduce Medicare costs, and no no one will be overseeing them.
    Just like the various boards and committees just like this one that exist in other departments, they are legally required to abide by the limitations stated in the same law that defined their scope and purpose. If they "go rogue" then action can be taken in court. Take the laws that define your Nursing practice for instance. Most of what you are held to legally was not actually written by lawmakers, rather lawmakers set general parameters, goals, and guidelines then established a BON to come up with the specifics. (Do you really want a lawmaker telling you how to be a Nurse?)

    Medpac is similar and some of what both Medpac and IPAB do may overlap, but currently Medpac does not perform the duties that IPAB was established for.

    Quote from SC_RNDude
    Here is a scenerio that is easy to imagine.

    The board decides that to save x number of $$$, no one over 80 will get a knee replacement. Is this rationing? I would say yes, some might say no. Doesn't matter. Who is going to say they can't implement this?
    Nobody would say no, that would clearly be rationing. If there were clear and substantial evidence that it was impossible for anyone over 80 to benefit from knee replacement then that would not be rationing, that would be using evidence based practice to stop flushing money down the toilet, which is very different from rationing.

    Quote from SC_RNDude
    Or, they could raise taxes to pay for Medicare? The bill says they can't, but it also makes them immune from any process that could stop them from doing so.
    They have no mechanism to raise taxes. They are not immune from the legal limits placed on them.

    Quote from SC_RNDude
    "Congress will stop them", you say. Well, to do that, both houses of Congress AND the President have to agree on an alternative. They have to figure out an alternative way to save the same amount of $$$. They aren't going to. Why would they? They created this board to make the decisions they don't want to be responsible for.
    You lost me there.
  2. 0
    quote from: MBARNBSN: "I have yet to meet one in person that agrees. I also have yet to meet a person living and working in Massachusetts that hates his/her government-run health program."

    I just had a recent conversation with a friend who's elderly mother has had her healthcare benefits cut she also has a huge deductable ($4000.00) leaving her to pay 100% of her perscription medications. She, by the way, lives in Massachusetts.

    This quote below is from this article Consumer Power Report: In Massachusetts, Government-Run Health Care Forever | Heartlander Magazine

    "In Massachusetts, the ramifications of then-Governor Mitt Romney’s health care law are clear: more people are covered (though not everyone), the overwhelming number of whom are taxpayer-subsidized, by health insurance; access is an increasingly troublesome issue; and costs have only continued to rise."

    Tax payer subsidized healthcare??? I wouldn't mind having a health insurance policy that "someone else paid for & I had no deductable or co-pays either. But that is not reasonable, it is a system that is failing.

    There are a few details of The Affordable Healthcare Act that I do agree with, such as children being covered through their parents until 26 yrs of age, and for pre-existing conditions. It is our prior disfunctional system that has cause both of those details to be an issue in the first place, namely greedy health insurance companies given such control over healthcare. Young adults should have access to their own insurance without the need to forfiet and entire weeks pay, and pre-existing conditions should have never been a reason for decline in payment. We do need affordable health care, maybe universal healthcare is the answer, but the way it is being transitioned right now is neither affordable or equally universal to all.
  3. 2
    Quote from HolisticNurse97
    quote from: MBARNBSN: "I have yet to meet one in person that agrees. I also have yet to meet a person living and working in Massachusetts that hates his/her government-run health program."

    I just had a recent conversation with a friend who's elderly mother has had her healthcare benefits cut she also has a huge deductable ($4000.00) leaving her to pay 100% of her perscription medications. She, by the way, lives in Massachusetts.
    I'm curious about why your friend's "elderly mother" isn't on Medicare? This story sounds extremely fishy to me -- sort of like all the stories of how people are dying in the streets from lack of care in Canada and the other countries with universal coverage.
    Sisyphus and wooh like this.
  4. 0
    Quote from MunoRN
    VRBO is what my mac autocorrected IPAB to (I'm surprised it didn't correct to IPAD). My bad.



    Just like the various boards and committees just like this one that exist in other departments, they are legally required to abide by the limitations stated in the same law that defined their scope and purpose. If they "go rogue" then action can be taken in court. Take the laws that define your Nursing practice for instance. Most of what you are held to legally was not actually written by lawmakers, rather lawmakers set general parameters, goals, and guidelines then established a BON to come up with the specifics. (Do you really want a lawmaker telling you how to be a Nurse?)

    Medpac is similar and some of what both Medpac and IPAB do may overlap, but currently Medpac does not perform the duties that IPAB was established for.



    Nobody would say no, that would clearly be rationing. If there were clear and substantial evidence that it was impossible for anyone over 80 to benefit from knee replacement then that would not be rationing, that would be using evidence based practice to stop flushing money down the toilet, which is very different from rationing.



    They have no mechanism to raise taxes. They are not immune from the legal limits placed on them.



    You lost me there.
    Although I have seen various opinions to exactly what extent, IPAB's actions are at least somewhat immune from judicial review. Here is text from the law:
    ‘‘(5) LIMITATION ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the implementation by the Secretary under this subsection of the recommendations contained in a proposal.”
  5. 0
    Quote from MunoRN
    VRBO is what my mac autocorrected IPAB to (I'm surprised it didn't correct to IPAD). My bad.



    Just like the various boards and committees just like this one that exist in other departments, they are legally required to abide by the limitations stated in the same law that defined their scope and purpose. If they "go rogue" then action can be taken in court. Take the laws that define your Nursing practice for instance. Most of what you are held to legally was not actually written by lawmakers, rather lawmakers set general parameters, goals, and guidelines then established a BON to come up with the specifics. (Do you really want a lawmaker telling you how to be a Nurse?)

    Medpac is similar and some of what both Medpac and IPAB do may overlap, but currently Medpac does not perform the duties that IPAB was established for.



    Nobody would say no, that would clearly be rationing. If there were clear and substantial evidence that it was impossible for anyone over 80 to benefit from knee replacement then that would not be rationing, that would be using evidence based practice to stop flushing money down the toilet, which is very different from rationing.



    They have no mechanism to raise taxes. They are not immune from the legal limits placed on them.



    You lost me there.
    Your example of what is "very different from rationing", to me, clearly is rationing. Which is another problem with the law as it describes what IPAB is prevented from doing. That is, it does not define what rationing is.

    And when they do ration, it will be more indirect than what I described. They will not say "people over 80 will not get a knee replacement". Instead, they will simply cut down reimbursement rates for knee replacements for people over 80.

    So, you believe that if EBP says that people over 80 can not benefit from a knee replacement, that NO ONE over 80 should get one? You believe that a gov't committee should determine this instead of a physician and patient working together?


    Substitute "heart valve replacement" for "knee replacement", and you sound like one of those conservatives who supposedly "want to throw grandma over a cliff."
  6. 0
    Quote from elkpark
    I'm curious about why your friend's "elderly mother" isn't on Medicare? This story sounds extremely fishy to me -- sort of like all the stories of how people are dying in the streets from lack of care in Canada and the other countries with universal coverage.
    She was cut from Medicaid...no coverage at all any longer with that...she does have Medicare, which she had to pay a $4000.00 deductable for a hospital admission plus she no longer has all her perscriptions covered as she did with Medicaid. Medicare is cutting payment through reducing benefits for the elderly and a reduction on reimbursment to hospitals. What IS fishy about that is that medicare is making cuts to benefits, their cuts are not making healthcare affordable.
  7. 0
    Since trust has been shaken over agencies or companies that have been entrusted to safeguard the people, I for one am interested to know how many people's medical condition will deteriorate while waiting for a procedure to be green-lit? That concerns me.
    I'm not sure with the change in the leadership every few years that these boards would be bias-free.

    We are a very large country (we can fit lots of countries in our country) with a large population with different demographics. There are vast areas that are underserved. We also have people coming here from other countries (if you live in FL you know what I'm talking about) who live in their home country during the summer and live on the beach for the winter-to obtain medical care in the US. States with low populations will probably depend on the gov't more than those who have a larger populous that can balance out the costs.

    JCAHO has now been tied to CMS to inspect and report any violations-which if not corrected would end any reimbursements from Medicare patients,etc. This is a big power grab. I support safety measures-and applaud some of the changes, but some are completely without merit. Very strange scenarios are presented that would probably occur with these mandates in place.

    The one thing I do know, is that these rules and changes are supported until you have been impacted personally. Then you can actually see how it works or doesn't work. Lots of things sound good until you get really sick and will be dealing with the bureaucracy.

    The one thing that has happened, since the pocket book has been threatened, hospitals/doctors/other healthcare providers, are cleaning up their act. They see more and more of their patient population dwindling, profits going down, and are scrambling for ways to promote procedures that bring dividends. That's great-we are in the business of taking care of sick people or those who need corrective or elective care/procedures. It's strange that we built a business around sickness, but that's the business we are in. Promoting wellness defeats our purpose so to speak-funny. It will in 20 years or so completely restructure the type of business we are in. You see already many doctors giving up the management of their own private practices and becoming employees of the hospital network-they can't keep up with the regulations or requirements (ex. EHR software) that's big change.

    It is going to be interesting-if you think about it, it is a good time to be a nurse.
  8. 6
    Sensibility,

    You need to stop watching Fox News first.
    Second, Food prices are going up because of the drought that has covered most of the central and southern US. That has nothing to do with either party. (unless you believe in global warming which is being blamed on Republicans.)
    http://www.nytimes.com/2012/07/26/bu...e-drought.html

    Third, Gas prices going up also has nothing to do with either party nor any president. If you'll remember, it was under Bush that gas prices skyrocketed in the first place. It's Wall Street that controls that. And if anything Obama has wanted to hamper their ability to screw with those prices but has been blocked by the Republicans.
    How Wall Street Is Raising the Price of Gas - ABC News

    As far as Taxes, Under Obama, according to Politifact.com, they've cut taxes for small businesses not once, not twice, but 17 times. The average family’s tax burden is among the lowest it’s been in the last 60 years. And, for the middle 60 percent of the income distribution, both the average tax paid and the average tax rate fell between 2008 and 2011.
    PolitiFact | Barack Obama says taxes are lower for middle class today than when he took office
    To the point you made "Eventually, some treatments will be denied and people will die." Excuse me, but insurance companies are doing that right now. There are already people dying because some corporate big wig says a treatment is experimental (aka too costly).

    So again, I beg that you stop listening to the right wing controlled media and do some searching the for the truth yourself. Obama has done more for the middle class than any president in 60 years. I'm not trying to sound nasty, I'm just very frustrated because so many people are believing all of the lies from the extremist right wing media without doing some fact checking- my family included.

    J

    Quote from Sensibility
    You don't necessarily need to be a nurse to be a member of this board. Nobody checks to make sure. Please be careful of people that might very well be plants who are obviously giving fallacious information to support socialized medicine. The one guy that said that we have 700 billion dollars in reserve for this is flat out lying. Jeweles26 is giving the right information. We are going to see huge cuts in our salaries and our taxes will go out of the stratosphere meaning less money. Will we be able to reverse this once we're in? Probably not. Most people who support the democratic agenda are constantly arguing that republicans put money into the pocket of the rich. I am sick to death of that argument because it is not true. What a system like the republicans propose does is allow people to prosper, which then causes others to prosper. It means that those people have ability to hire other people and more and more money is available to spend on the things we like. It is just a fact of life that some folks are have more money than others but those people generate jobs for others and hire small businesses to do work etc. My husband's small business is nearly going under with this democratic government especially because of food and gas prices and taxes. See, if you start out with a small business idea, you can prosper under a republican government. Often those who don't have money are the ones who don't want to work. Technically, you could get by in this world with just a few basic items and they want the government to provide those things instead of working hard and making something of themselves. Under a democratic government, it is impossible to prosper because if you make more money, it is less because it places you in a tax bracket where you have to pay more out. So in essence, your situation hasn't changed even though you are supposedly making more. Can you see that? The socialized health care will only further that agenda. Eventually, some treatments will be denied and people will die. Why? Simply because there is not enough money for chronic illnesses that might burden the system. Guess who will survive those things? People who happen to have money. So again, the rich are the only ones who prosper under this where today, those same people get excellent care.
    ticklemern, Sisyphus, elkpark, and 3 others like this.
  9. 2
    Quote from wooh
    I don't think "fallacious" means what you think it means if you're calling the fact that countries with socialized medicine have lower infant mortality rates and higher life expectancies "fallacious."

    But good warning. You don't have to be a nurse. The Koch brothers certainly have the money to pay people to spread lies like calling the ACA "socialized medicine." Quite a few people in this thread that could be right wing plants trying to scare nurses into thinking we're going to make less money and all wait in line for pap smears because of ACA. When most of us (the vagina owning ones) already had our pay threatened by Paul Ryan voting against the equal pay for women act. Which I guess is good for small business, if they only have to pay their penis owning employees a fair wage, they can afford the goods and services whose prices have skyrocketed thanks to the Republican deregulation of the financial industry... Which apparently Barack Obama was supposed to wave a magic wand to fix our economy overnight even though those bankers had a few years to screw it up? Maybe he should have taken a page out of Mitt Romney's business model and sent the job of fixing our economy overseas?
    LMBO!!! Right wing plants? I could say the same about you, you sound like you could definitely be some illogical left-winger so far! You speak about the right-wing spreading lies? What about the current lies coming out of the mouths of the Obama administration, including the president himself? All the things they are saying to demonize the right are about as funny as they are insulting! I am no 'plant'. I am in fact a Canadian RN who LEFT the country because I was SICK AND TIRED of paying more than half of my very hard earned salary for people who dont want to work and use the ER as a primary care physician. And they have to, that is the sad part. Why you ask? Because of socialized medicine. Less money going into healthcare means lower salaries, which means less people wanting to stay in this work force. Sure, I love my job. I love taking care of people, making them better, helping them lead healthier lives. But I have a family to support, on top of supporting millions of others with my tax dollars.
    If you really dont think the ACA (There, you happy?) will change things in regards to your taxes (and yes, it WILL be the middle class who will feel the hardest sting to their pocket books, not the rich, like Obama would like you to think. Again, I speak from experience), then you are sadly mistaken. Salaries will decrease. Might not be overnight, but it WILL happen. When the hospital has less money to spend, who do you think will suffer from it? They will hire less staff. They will spend less on equipment. They will stop giving pay raises. Just wait and see.
    And by the way, having a penis or a vagina has NOTHING to do with ANYTHING, other than the fact that the president is trying to make the mindless masses believe that republicans hate women. Once again, I LMBO.
    HolisticNurse97 and SC_RNDude like this.
  10. 0
    Oh, and telling people to stop watching Fox news because of its right-wing affiliations? Please. Maybe you should add it to your repertoire after you watch ALL of the other left-wing news networks to at least get two sides of the story, and make your informed decisions from there...


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