Obamacare: Should I get out while I still can? - page 4
Hello :) I didn't know exactly where to ask this, but I am very concerned and need some guidance...I am just about to take prerequisites to get into a BSN program. I would really love to be a nurse!... Read More
1Nov 11, '12 by BlueDevil,DNPAmanda, most of your "facts" are just patently untrue. I won't bother with them individually, it isn't worth the time. Rather, I will point you to the MIT economist and perhaps the foremost expert on health care policy in the country, Jon Gruber, who helped author BOTH of the early proposals that have evolved into what you refer to as Romney care and Obamacare. In his, expert, opinion they are fundamentally the same. Forgive me if I defer to his opinion on this matter rather than yours or the pundits'. FWIW, he wrote both a traditional text book and a comic book. If you care to delve further into the subject, you can choose the format you prefer.
Romneycare, Obamacare, and reform after tomorrow
1Nov 11, '12 by AmandaVanGuilderI am not interested in slinging mud and have no desire to stoop so low. I am allowed an opinion as are you. I am simply putting information out there. I am not asking for anyone to agree with me. I was just giving an answer in response to a previous post. I do not favor Obamacare. I have read multiple documents that outline Obamacare and after doing much research have come to my own conclusion. I do not for see it providing a true solution to our problem. We will see how it does play out in the long run. I will be elated if the program is successful but I am suspicious.
1Nov 11, '12 by Susie2310Quote from DoGoodThenGoPlease could you direct me to the source/s where you found that physicians as a group according to polls did not support Obama. I could not find this information in a google search.Didn't take long post election for the Speaker of the House, John Boehner to issue a statement saying "Obamacare is the law of the land". So like it the thing is done and we all must bear it as best we can.
Not only did Obama win re-election but Democrats held and increased their seats in the Senate in many cases with far more liberal members than before. In short several themes seem to have emerged from the election results including a majority of hte population believes the federal government should be *more* involved affairs such as healthcare.
Physicans as a group in whole according to polls did not support Obama, and now it remains to be seen how they respond to the changed landscape. However two trends that began before the election probably are going to continue; more doctors are going to give up private practice in favour of being "employed" by hospital systems, and physicans who can are going to decline all type and sort of insurance/entitlement programs in favour of cash payment up front. From there patients will have to submitt claims to get their money back.
As it relates to hospitals/healthcare systems the push from the federal government to drive down costs is most certainly going to be felt in one way or another by the nursing service. Hospital/bedside nurses probably looking at yet more paperwork, doing more with less staffing, adjusting to creative and or innovative staffing methods as hospitals seek to fine tune census to nurse ratios.
In many areas of the country there is probably going to be more mergers and or closings of hospitals as the weakest either shut down or absorbed by larger systems. That again continues another trend in healthcare; the larger the system the better able it will be to demand better reimbursement rates from insurance companies and so forth. One foresees hospitals/heathcare systems moving more towards a type of vertical integration system where they are not only providers of healthcare but insurance as well.
Look also for more out sourcing such as what a hospital in Westchester recently pulled off; terminating all employed NAs then contracting out that service to an agency.
Long story short it took generations to build up the private healthcare system in the United States, and many are going to have to be dragged kicking and screaming into any sort of world that even smells of what they associate with "socialised" medicine.
5Nov 11, '12 by MunoRNQuote from AmandaVanGuilderI appreciate the thought you've put into this, and breaking these issues down is a good idea, although many of your statements are incorrect. First it's important to note that Romneycare and Obamacare have many key similarities, but are not exactly the same; they have two very different scopes. I should also clarify that I don't like Obamacare either, it's essentially a Republican bill, most of what Republicans are complaining about could have been fixed if we had gone with the more progressive proposal of single payer, non-profit/government option, and best practice requirements.BlueDevil DNP: ACA and Romneycare are different in many ways. I am opposed to taxes going up because they don't have to at all. In fact Romney proved that with the implementation of Romneycare. Although it is nice to trust what the mass media tells us about Obamacare and how it is so similar to the very successful program that Mass has in place now, they are lying to you! It's high time we start doing our research instead of just accepting what information we are fed. We must be wise consumers. Here is an outline of the vast differences. RomneyCare VS ObamaCare
I included my responses within your list (bracketed, bolded and italicized), I don't know if this makes it any easier to read or not.
- RC - Applies to only 8% off MA workers that were not insured. [Regulations to plans affect 100% of plans, affecting 100% of residents] OC - Applies to 100% of Americans
- RC - Bill is 70 pages long [229 pages long actually]
OC - Bill is 2000-3000 pages long (28X greater) [995 pages long, <5x greater]
- RC - Romney VETOED 8 parts of the Bill before it was passed [All of his vetoes were overriden]
OC - Obama VETOED 0 parts of the Bill & has not read the entire bill [The bill included 160 Republican amendments, many of which I'm sure Obama would have liked to have seen gone, but he was trying to make a bipartisan gesture (which got him nowhere).]
- RC - Written by Office of Govenor MITT ROMNNEY [The Governor's office made a proposal to the Legislature who then wrote the bill that was passed.]
OC - Witten by . . . . ? [Written by the Senate Finance Committee - 3 Democrats and 3 Republicans]
- RC - Funded by existing revenues [Funded by both individual and employer mandates]
OC - Paid for by borrowing money [Also funded with mandates, No additional money is borrowed due to ACA, actually it decreases the deficit by $212 Billion between 2012 and 2021]
- RC - Did not raise taxes [Tax/penalty ranges from $228 to $1,212 per year]
OC - Raises taxes [Tax/penalty ranges from $97 this year to $695 when fully phased in]
- RC - Inforced by Massachutes Health (MassHealth) [Tax/Penalty enforced by the Mass Dept of Revenue]
OC - Inforced by the IRS [Health Provisions of the Act enforced by the Dept of Health and Human Services]
- RC - Adopted by 67% majority vote in MA (2/3rd)
OC - Forced thru Congress and has no Bi-partisan support (Obama Democrats only) Backroom deals [Written by a bipartisan committee, included 160 Republican amendments, written during 31 Bipartisan meetings between June and September of 2009]
- RC - Leaves 0.02% of children un-insured [the Mass uninsured rate was 4.1% in 2012, Romney's initial proposal didn't include additional measure to insure children, that was added by the legislature.]
OC - Leaves 11% of children un-insured [leaves 7% uninsured by 2022, the Romney/Ryan proposal to change healthcare reform would triple that.]
- RC - Doesn't affect / cut Medicare [It's a state law, legally it can't alter medicare]
OC - Reduces Medicare Benefits [Specifically states it cannot reduce Medicare benefits]
- RC - Ruled as Constitutional
OC - Ruled as Unconstitutional twice (so far) [Ruled constitutional by the Supreme Court]
- RC - Does not Regualte Health Care Industry - works with Healthcare Providers and Private insurance companies [Romneycare actually operates under some of the most complex regulations on health care plans in the country]
Oc - Regulates 100% of the Health Care Industry - Forces Healtcare Providers and Private insurance to comply. [Includes similar regulations for plans, leaves state specific regulations in place]
- RC -
OC - caused the loss of many democratic seats in Novemeber of 2011 [Democrats usually aren't happy when their representatives pass a law that is tailored primarily to Republicans]
- RC - Still in effect in MA
OC - Budget concerns, Constitutionality of mandate in question. [The CBO's current projection is that Obamacare will REDUCE the deficit by $210 billion. The supreme court has already ruled on the mandate, which was a core principle of Republican healthcare policy]
- RC - Don't like it - Try another approach
OC - Don't like it - Tough! [The mechanism for changing both Romneycare and Obamacare is the same]
- RC - Stayed on Budget Projections [Romneycare is on track to exceed it's $1.8 billion budget by $150 million this year year]
OC - Went over budget by 100% (can Obama add?) [I assume you're referring to the claim that the CBO reported an increase in cost from $940 billion to $1.76 Trillion, which is not actually what the CBO report said. This reflected only a portion of the equation (costs), missing that as costs go up so do savings, the CBO actually said that the gross costs of the insurance provisions have gone up 9%, but there are also been increases in savings, resulting in a NET cost DECREASE of 0.64% from previous projections.]
0Nov 11, '12 by mariebailey, MSN, RNI do not understand the interest in comparing Obamacare to Romneycare. Is it truly a matter worthy of debate? The healthcare policies Romney planned on implementing at the federal level did not resemble his reforms in MA at all. In fact, his proposed Medicaid reforms would have led to drastic cuts in MA b/c the state receives federal Medicaid dollars. Regardless, it is a moot point b/c he was not elected!
2Nov 12, '12 by BlueDevil,DNPQuote from AmandaVanGuilderNo one is "slinging mud" except perhaps whomever wrote the inaccurate piece you cut and pasted, lol. I am a bit perplexed that one would be disinterested in reviewing data (facts, in this case) gleaned the foremost expert in the country and the original author of both pieces of legislation in question on which to base their opinion while their doing their due diligence in "research," but, um, ok. As you say, you have come to your conclusion.I am not interested in slinging mud and have no desire to stoop so low. I am allowed an opinion as are you. I am simply putting information out there. I am not asking for anyone to agree with me. I was just giving an answer in response to a previous post. I do not favor Obamacare. I have read multiple documents that outline Obamacare and after doing much research have come to my own conclusion. I do not for see it providing a true solution to our problem. We will see how it does play out in the long run. I will be elated if the program is successful but I am suspicious.
0Nov 12, '12 by AmandaVanGuilderThere are ever evolving sites of information and continue to be projections as to how Obamacare will effect this country. Both negative and positive. I have read multiple sources and looked at many documents. I have also read credible sources which despute Mr. Grubers statements and site him as having flip flopped on his projections. I can sit here and be rude or I can take your constructive criticism and I do accept that you may have a different view of things. It is just fine and I welcome it. Most healthcare professionals who are required to complete documentation on a daily basis will admit that Medicare has ever increasing regulations. It has become increasingly difficult for healthcare facilities to receive payment for services that they have provided to individuals. Medicare is a broken program, and that is the reality of the situation. I forsee another federally funded program that will leave us all with greater restrictions, more federal regulation, and a decrease in payment of services. I will also note that first hand I have seen a decline in patient care, as clinicians are required to spend increasing amounts of time on documentation. We can sit here and talk numbers, make projections, and even refer to an "expert" who says, but the harsh reality is that history and experience do not lie. There are many nitpicky issues, loopholes, and figures that we can site all day long. I don't see any of these numbers truely getting to the heart of the matter for our patients or ourselves. I wish there was a better way. I still believe that Romney implemented a program that overall has proven successful for Mass. I also believe that there is a better way for us to fix our issues regarding health insurance in this country. I will never agree with you that Obamacare is a great thing and that it will fix our problems. I see it as a band-aid and I also see it as causing more harm than good in the long run. We will have to wait and see. My main concern is how this will effect patient care, our work as nurses, and our paychecks. I have to accept that it is the law of the land, but I will never say that I thought it was a good thing.