Obamacare and Nursing.. what do you think? - page 4

by OKNurse2be 54,540 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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    Quote from Medic2RN
    Actually, that is incorrect. Obamacare changes began in 2010.

    http://blog.heritage.org/wp-content/...rt4-8final.pdf
    Actually, "because almost none of it takes effect for 2 more years" is a pretty fair description, some changes took place in 2010 through 2013, although the bulk of it and the most substantial changes begin in 2014.
  2. 0
    Anytime bureaucrats in government start making healthcare decisions, with NO healthcare experience, it concerns me.

    The post office isn't a monopoly on parcel/snail mail, but it's always in deficit, debt, and if it was a private business- would have been bankrupt long before I was born.

    Many hate the capitalism aspects of Medicine, Pharmaceuticals, and healthcare- but it's also why we get a much much bigger paycheck than UK, Canadian, or Irish Nurses.

    I had a British Nurse Educator at a large Southern US University tell me, "find out what your local public school teachers make, and you'll get a better idea of what you'll make in that area(warning about future effects of a centralized system of Government Controlled Healthcare)."
    Last edit by BostonTerrierLoverRN on Nov 14, '12
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    There are 40, maybe 70 million uninsured in America. Another 100 million can't afford to USE their insurance, due to the high deductibles. The uninsured use ERs, and don't pay. Under Obamacare, 20 or maybe 50 million people will now be able to obtain insurance. How can adding millions of newly insured patients, indicate a monetary loss for hospitals? It can't, and doesn't. Hospitals are using it as a technique to save money (rather, see the end of this sentence), scare employees, and etc...but at the same time they are all spending billions on new construction (to be prepared for the huge influz of, paying patients)? For those of unaware of Obamacare, Wickipedia has an in-depth detail of the consequences, and benefits- the best I've seen, to try to make sense of the chaos that will happen in 2014. But there are going to be a LOT of winners, and losers..it all depends on your income, and whether your employer will retain you as full time and be required to provide you a plan. The biggest losers will be individual plan owners with significant incomes- your premiums will 'explode', and also employees that are cut below full time, and forced into the individual plan system. The biggest winner? HOSPITALS, since almost everyone will now have insurance to pay THEM.
  4. 2
    That whole "pass it to find out what's in it" thing still bothers me.
    IowaKaren and fairyluv like this.
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    Have you seen how much insurance premiums are going up due to Obamacare?6.3% Health Premium Increases Projected for 2013
  6. 4
    Quote from BostonTerrierLoverRN
    Anytime bureaucrats in government start making healthcare decisions, with NO healthcare experience, it concerns me.

    The post office isn't a monopoly on parcel/snail mail, but it's always in deficit, debt, and if it was a private business- would have been bankrupt long before I was born.

    Many hate the capitalism aspects of Medicine, Pharmaceuticals, and healthcare- but it's also why we get a much much bigger paycheck than UK, Canadian, or Irish Nurses.

    I had a British Nurse Educator at a large Southern US University tell me, "find out what your local public school teachers make, and you'll get a better idea of what you'll make in that area(warning about future effects of a centralized system of Government Controlled Healthcare)."
    Even in the for profit health care system nurses are not big winners when it comes to wages, even though the health outcomes for patients are clearly fixed to our professional efforts and duties.

    Most of us expect a reasonable wage for our professional services, but most are not looking to get wealthy...one doesn't choose nursing as a career path if wealth is your goal.

    The US post office is in trouble because of the activities of our legislators who seem to possess little in the way of "critical thinking" skills.
  7. 4
    Quote from lossforimagination
    Have you seen how much insurance premiums are going up due to Obamacare?6.3% Health Premium Increases Projected for 2013
    Have you seen how much insurance premiums have gone up before Obama even took office?


    "Since 1999, health insurance premiums for families rose 131%, the report found, far more than the general rate of inflation, which increased 28% over the same period.""The annual survey of more than 2,000 companies also found that 40% of small-business employees enrolled in individual health plans pay annual deductibles of $1,000 or more. That’s almost twice the number who paid that much in 2007."
    Wasn't Bush in office during 2007? Hmm....
    Amnesty, Not_A_Hat_Person, laborer, and 1 other like this.
  8. 1
    Quote from CA ER Nurse

    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?
    I think this brings up an interesting question. Until some semblance of personal accountability takes hold in the mindsets of those who abuse entitlement programs and other protections provided by law, the ACA will never achieve the goals that Obama and its other supporters had in mind originally. While most receiving government assistance do so out of absolute need and actively made strides to better themselves, there still exists those who treat public assistance programs as God-given rights and often times as a way of life or livelihood. Or those who treat EDs as primary care, one-stop healthcare malls that are designed to operate and address any health concern that arises no matter the severity. Those are the people who utilize EDs to treat early pink eye, to provide "a hot and a cot", hangnails, UTIs, repeated STD prophylaxis, etc. Why is that? That's because they currently suffer no consequences for repeatedly abusing the system. That's in large part due to laws like EMTALA where the federal government is able to specify and regulate what services healthcare professionals must render without regard to a patient's ability to pay for such services despite the fact that monetary means is what keeps hospitals operational. Unfortunately, many EDs continue treating patients with chief complaints that are inappropriate for the emergency department or patients whose lifestyles and/or noncompliance create the need for emergency treatment time after time out of fear of violating EMTALA. If only more EDs adopted medical screening exams prior to triage that could help weed out the nonsense use of emergency services that clogs up EDs in America everyday. While appropriate emergency treatment should be a mainstay aspect of all EDs, facilities should have the ability to consider patients' abilities to pay for services rendered when the patient is utilizing the emergency department for non-emergency conditions.

    As for those who ignorantly and blatantly utilize emergency care without health insurance (i.e. homeless) more so for hospitality services, hospitals need to create environments that aren't as comfortable or hospitable. Meal trays, sandwiches, bed with cover, etc need to be replaced with bread and water and really hard stretchers that would make anyone want to get out as quickly as possible.

    The mentality of Medicaid needs a serious makeover. Indiscriminate and inappropriate use of emergency resources should no longer be an option for those who have medical assistance. Currently there is no deterrent, financial or otherwise, to discourage abuse of emergency services by those on medical assistance. Whether someone on MA is experiencing a true emergency or simply wants a pregnancy test, many times treatment is rendered in the ED and the MCO (managed care organization) pays up without any copayment or deductible required from the patient. With the insurance provided by my employer, I can go to any ED at the drop of a hat whenever I'd like, but then I have to fork out a $150 per visit. As much as I would love to have most treatment options available to me in one place like X-ray, surgery, lab, etc, the $150 copay is enough of a deterrent for me to utilize my PCP for non-emergency complaints instead. I wholeheartedly believe that requiring someone to pay an amount as small as $10 for treatment that is determined to be non-essential during a medical screening exam would be enough of a deterrent for many people who frequently misuse emergency services.

    Those who misuse emergency services are doing nothing short of committing fraud. Doctors and other healthcare professionals should be able to report such abuse to CMS as if it was being reported that a physician was billing Medicare for fraudulent claims.

    Without implementing drastic changes to the laws and programs that greatly affect how EDs in the US operate on a daily basis, any attempts at improving healthcare in this country will be lost causes IMO.
    IowaKaren likes this.
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    "As for those who ignorantly and blatantly utilize emergency care without health insurance (i.e. homeless) more so for hospitality services, hospitals need to create environments that aren't as comfortable or hospitable. Meal trays, sandwiches, bed with cover, etc need to be replaced with bread and water and really hard stretchers that would make anyone want to get out as quickly as possible."

    Could we try other, more compassionate options before we go this direction?
    The 47% are taking this country down the tubes it sounds like.
    laborer likes this.
  10. 0
    Quote from tewdles
    "As for those who ignorantly and blatantly utilize emergency care without health insurance (i.e. homeless) more so for hospitality services, hospitals need to create environments that aren't as comfortable or hospitable. Meal trays, sandwiches, bed with cover, etc need to be replaced with bread and water and really hard stretchers that would make anyone want to get out as quickly as possible."

    Could we try other, more compassionate options before we go this direction?
    The 47% are taking this country down the tubes it sounds like.
    Such as? FTR, I wasn't referring to the occasional misuse of emergency services. I'm talking about situations where on a daily basis-if not multiple times per day-EMS picks up a "regular", drunk homeless person, and transports them to the nearest ED "to sleep it off". Once the booze wears off, the regular is demanding food, warm blankets, clean scrubs, bus tokens, and even medical treatment for their self-inflicted health problems. The ED has become their personal hotel. Emergency departments should be able to make abuse of their services less readily available. I'm not really sure how "more compassionate options" would help a population of people that obviously lacks the desire for self-improvement to adopt a lifestyle that embraces personal accountability.


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