Obamacare and Nursing.. what do you think? - page 3

by OKNurse2be

52,123 Views | 160 Comments

I know that I am possibly opening up a can of ugly worms. I hope that in spite of differing opinions, that this thread can remain friendly and a simple exchange of ideas and opinions. As a beginning nursing student, I am... Read More


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    Obamacare isn't perfect, but it's something. Medicare was instituted in 1 year, and has been revised several times since. I don't remember all this outrage over Medicare Part D, which forbids Medicare from negotiating drug prices. Buying meds from Canada isn't a solution. Canadian meds are cheaper because the Canadian government regulates drug prices. It's not the Canadian government's job to provide cheap meds for Americans.

    Separating health insurance from employment is a step in the right direction. Right now, when companies drop their health insurance coverage, employees have no options except COBRA, which is very expensive and only good for 18 months. If they can buy into Medicare or some other single-payer system, they will have other options besides waiting until they're eligible for Medicare.

    I hope Obamacare leads to national ratios for inpatient and outpatient care, especially LTC. Hospital-level patients need hospital-level staffing and resources.
    malamud69, casi, RNFiona, and 1 other like this.
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    People dont seem to see any of the large problems with the whole notion of the "Affordable Care Act". The true problem is the government is trying to rule the private market. Without a Federal based healthcare insurance policy for the people, we can NEVER have a system that will work (this is not something I want).

    We are using private "for profit" companies to fund the healthcare system. If we look back at Romneycare and the effects it had we can see that private for profit companies cannot make a profit under the system. BCBS I believe went non-profit in their state to find out they would lose money all together. They tried to stop selling insurance in the state when the state sued them to force them to sell insurance.

    The government has offered a solution of forcing people to enter into a contract between a person and a private company or pay a tax. These companies are here to make a profit. Many people have NO understanding of "pre-existing conditions" and until they do, they will never understand what is going on. The law under I believe HIPAA states an insurance company may deny coverage for a pre-existing condition up to I believe 18 months for every month of coverage they did not have prior to acceptance into a new program after a lapse of 62 days without credible coverage. So let me give a better example as this happened to my fiance:

    My fiance is diabetic type 1 and depends on insulin. When changing jobs, she had a lapse of coverage of 1 month. Since she had a lapse of less than 62 days, she was not denied any coverage for her pre-existing condition (she was forced to show a letter of credible coverage). Had she had a lapse of coverage for 62 days or more, then new company could have denied her short term. So if her lapse of coverage was 62 days, they can deny covering her medications for 62 days. If she had a lapse of one year, they can deny her coverage for insulin and appointments for 1 year. I believe the cap is 18 months on denial of coverage.

    This makes perfect sense. I would not be fair for someone to not have coverage for 5 years, get diagnosed with cancer and jump on a plan. The plan could deny him for up to 18 months of coverage for the cancer treatment. If they did not do this, all insurance companies would go bankrupt. It is very simple math. A single person can easily wipe out the monthly premiums received from a whole office of people.

    Also, until we see the reality of pharmaceutical companies, we will never get it. Have you seen the drug shortages lately? There is not enough profit to make some of these generic medicines such as morphine, versed, etc. By increasing taxes on pharm companies this will reduce the incentive for companies to make these medicines even more. But we will do what we always do and subsidize certain companies and medications. The government already has a hard time getting companies to research and develop vaccines. Great idea, lets tax them too. Technological advancement slows when you reduce incentive to produce and thrive. A pharm company totally deserves the money they make on a medication. If you do not believe they do, why dont you start your own company? Many people do not see the MILLIONS of dollars invested into medications that are not passed by the FDA or are passed and later taken off the market. Then you have people who sue to issues related to the medications for decades after the drug was pulled. They have lots of risk with a hope of coming up with a new revolutionary medication. With risk comes reward...when you take away part of this reward, people risk less.

    This goes on and on. The true problem is ignorant people with ideals that are in the clouds.
    TriciaJ, mdimples90, trudlebug, and 5 others like this.
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    The Health Care Reform in my opinion seems great for those that are struggling to make ends meet and suffering from true health conditions. But yet it will become detrimental for health payers that are great at preventing diseases. Health Care Reform will enable everyone to get insurance (and force tax-payers to pay regardless if one sees a doctor or follows through with the prescribed regimen).


    As a county ER nurse in California there are countless of abusers of the health care system such as homeless people calling for an ambulance ride for no real problem (request food and want a warm place to stay and sleep) and ultimately end up leaving, narcotic drug seekers or what ever the case may be. These individuals most likely don't even pay for their own medical bills or even have any form of insurance. How is the Health Care Reform fixing this chronic problem?


    County hospitals are probably one of the first acute care facilities where resources are removed. Working in a busy trauma ER facility, seldom do we have CNA's or ER nurse techs creating an enormous problem for nurses. We are still required to take our load of patients but how are we able to adequately treat and manage our patients. Then administration demands that we work faster and see more patients to get the wait times down. I strongly feel that administrators and legislators should take the time to go to a facility for at least a day and see first hand what nurses have to deal with. Perhaps this will open their eyes to what really needs to change and where the money should be going.
    TriciaJ likes this.
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    Quote from OKNurse2be
    I know that I am possibly opening up a can of ugly worms. I hope that in spite of differing opinions, that this thread can remain friendly and a simple exchange of ideas and opinions.
    I grew up in a country with a socialistic government, which also includes healthcare for everyone. I have seen how the hospitals are understaffed, and you are lucky if you get to spend 5 minutes with your physician, and you are not in control over which healthcare facility you can go to. I know that the new bill isn't necessarily socialistic, but there are socialistic principles in it.
    How do you think that Obamacare is going to affect how care is delivered?
    By the way, this is NOT a homework assignment of any kind. I am merely looking for for a friendly exchange of ideas and opinions.
    There are many models of socialized medicine, & I think it varies from country to country the overall quality of care that can be expected. This documentary provides a great overview: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
    I
    t is my hope that, by providing more access to preventive services, we will eventually see a healthier nation. It is also my hope that health disparities and unequal access to care are diminished.
    casi and angeleyes8501 like this.
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    Quote from VANurse2010
    Please explain to me what is "socialistic" about the ACA. The government isn't taking over any hospitals or insurance companies.
    While I agree that it is not prototypical socialized medicine, I believe the OP is accurately pointing to the greatly enhanced government regulation of health services that is part of the ACA, which is a feature of socialized medicine. FYI: I'm all about healthcare reform, & the word socialism isn't scary to me.
    angeleyes8501 likes this.
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    I will not quote politicians or policy, I will give you the facts about what is happening right now in my hospital because of obamacare. I work in a large level 1 trauma center that owns 6 hospitals of varying sizes around the state. We have had 300 layoffs thru out the system with 150 of which were nurses. We were told it was because the hospital is "tightening the budget" getting ready for the impact obamacare will have on them. We are also a union hospital and I am on the negotiating team. We are working on a new contract as I type because our currant contract is up Dec 31, 2012. We have been told at the table, by management, there will be no pay raises in the new contract. We of course are negotiating with them, but so far they are holding firm. At this point right now there is a hiring freeze in place and new nurses are working as nurses aides because they can not find a job with in 50 miles of this hospital.
    October of 2012 under obamacare, the hospitals will not get paid if a patient is admitted with in 30 days of discharge with the same diagnosis. That is more than half my patient population!!! We call them "frequent fliers".
    If the hospital loses money, that trickles down to less nurses, which in turn, leads to poor patient safety.
    I don't really like the effect of obamacare on my hospital. What do you think?
    cristielf likes this.
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    Quote from thomnurse
    I will not quote politicians or policy, I will give you the facts about what is happening right now in my hospital because of obamacare. I work in a large level 1 trauma center that owns 6 hospitals of varying sizes around the state. We have had 300 layoffs thru out the system with 150 of which were nurses. We were told it was because the hospital is "tightening the budget" getting ready for the impact obamacare will have on them. We are also a union hospital and I am on the negotiating team. We are working on a new contract as I type because our currant contract is up Dec 31, 2012. We have been told at the table, by management, there will be no pay raises in the new contract. We of course are negotiating with them, but so far they are holding firm. At this point right now there is a hiring freeze in place and new nurses are working as nurses aides because they can not find a job with in 50 miles of this hospital.
    October of 2012 under obamacare, the hospitals will not get paid if a patient is admitted with in 30 days of discharge with the same diagnosis. That is more than half my patient population!!! We call them "frequent fliers".
    If the hospital loses money, that trickles down to less nurses, which in turn, leads to poor patient safety.
    I don't really like the effect of obamacare on my hospital. What do you think?
    That's one of the things I don't get about the whole thing. The whole not being able to get paid if patient is readmitted with same diagnosis. Some members of the population, like for instance the COPD patients, are very vulnerable to certain infections, which might have them in and out of the hospital on a regular basis. Should we force them to go to a different facility,when the one they were in the first time has their record? That disrupts the continuity of care!
    I see some of the good parts about the bill, which are the parts that most people would want to focus on, like coverage for pre-existing conditions. However, the parts that concern me is how the government expects to pay for this, and why are they supposedly cutting Medicare benefits which go to fund healthcare for a population that is generally very dependent upon it. Like stated about, if hospitals can't get funded (reimbursed etc) for the care that they provide, then that snowballs downhill and in the end not only do the patients lose but the healthcare providers lose too.
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    Quote from dh07RN
    You better just stop listening to mainstream media all together if you want real news. It's naive to believe that mainstream media portrays any truth whatsoever. It's also naive to believe that this country isn't in some serious trouble with finance...
    Exactly.


    Overall, I'm scared what it will do to employed nurses. I'm lucky enough to have finally found a job. Now I'm scared that because of the higher taxes, businesses will not be able to hire as many people as they want and therefore not have enough staff which increases nurse : patient ratio. This is not good. It's terrifying. I'm even scared of getting a pay cut.
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    Quote from LaceyRN12
    Exactly.


    Overall, I'm scared what it will do to employed nurses. I'm lucky enough to have finally found a job. Now I'm scared that because of the higher taxes, businesses will not be able to hire as many people as they want and therefore not have enough staff which increases nurse : patient ratio. This is not good. It's terrifying. I'm even scared of getting a pay cut.

    Even if this were true (and it isn't) Low taxes on the wealthy DO NOT create jobs. The past 10 years may have taught one this much... the only thing that creates jobs is DEMAND. or consumers. or a healthy middle class. Extreme wealth concentration,which we have, in part because of regressive taxation burdens, has stagnated job creation actually.

    As for all the people , presumably Mitt Romney voters, who claim that their hospitals are laying off nurses because they can't afford "Obamacare" (which pays for itself actually via the insurance mandates) that would be really really really odd...because almost none of it takes effect for 2 more years.

    The best part of the Affordable Care Act is that it uses technology to save costs. But maybe you'd rather that they kept reducing staff or payments for services instead...
    Last edit by serenity05 on Nov 11, '12 : Reason: spelling
    laborer likes this.
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    Quote from serenity05
    As for all the people , presumably Mitt Romney voters, who claim that their hospitals are laying off nurses because they can't afford "Obamacare" (which pays for itself actually via the insurance mandates) that would be really really really odd...because almost none of it takes effect for 2 more years.
    Actually, that is incorrect. Obamacare changes began in 2010.

    http://blog.heritage.org/wp-content/...rt4-8final.pdf


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