Are you worried about Obamacare, your job, and our patients?

BlueDevil,DNP, DNP, RN · Nov 10, 2013

I think we are all going to have full panels and full employment for NPs and PAs. The high demand is going to translate to a lot of money coming into primary care and salaries and bounses are going to rise commensurately if we meet HEDIS and meaningful use expectations. We are already seeing huge competition among insurers for the new medicaid contracts (my state opted in) because they are going to make tens, or hundreds, of millions of dollars. They are already hiring more employee to handle the volume. Just mediocre customer service level jobs, but it is a good entry level job for a lot of people, paying about $12 an hour and not requiring any education beyond high school. So the trickle down is going to be helpful in that regard. And in my state the expansion of medicaid is going to be a tremendous help for our uninsured and underinsured, and is expected to take a huge burden off our beleaguered emergency departments, and hopefully keep some of the from closing all together. That part remains to be seen.

I have no idea how it will effect acute care staff, since our goal in primary care, of course, is to keep patients out of the hospital! More people with access to primary care should mean eariler treatmet and less hospitalizations, but no one knows for certain that it will actually play out that way. There are fewer hospitalizations in the UK and Canada, if that is any indication, so I am hopeful that we will see improvements on that score here as well, but I think it is too early to be very optimistic that Americans are going to get less fat and lazy just because they can finally see a provider!

BrandonLPN, LPN · Nov 10, 2013

I find the whole cocept of "trickle down" economics a bit offensive.

We need more $10-$12 customer service an hr jobs in this country like a hen needs a flag.

I'm not so sure that the decline of acute care will lead to the only health care job growth being at the very top (providers, NPs, PAs) or the very bottom (MAs, UAP). There will still be a need for middle-ish income jobs like LPN and floor RNs. Rarely mentioned is sub-acute, rehab and skilled nursing. They stand to see explosive growth in an environment where acute care inpatient hospitalization is discouraged as being too expensive or too inefficient.

The decline of hospital inpatient stays doesn't mean a decline in inpatient nursing, just a realingment of where those jobs are going to be.

It seems very possible to me that Obamacare will lead to growth in the skilled nursing field. Many traditional med/surg patients can be adequately cared for much more cheaply in a sub-acute facility.

Not_A_Hat_Person, RN · Nov 11, 2013

I think Obamacare will expand opportunities for NPs and for nurses in home health, hospice, and SNFs.

BlueDevil,DNP, DNP, RN · Nov 11, 2013

I find the whole cocept of "trickle down" economics a bit offensive.
We need more $10-$12 customer service an hr jobs in this country like a hen needs a flag.
I'm not so sure that the decline of acute care will lead to the only health care job growth being at the very top (providers, NPs, PAs) or the very bottom (MAs, UAP). There will still be a need for middle-ish income jobs like LPN and floor RNs. Rarely mentioned is sub-acute, rehab and skilled nursing. They stand to see explosive growth in an environment where acute care inpatient hospitalization is discouraged as being too expensive or too inefficient.
The decline of hospital inpatient stays doesn't mean a decline in inpatient nursing, just a realingment of where those jobs are going to be.
It seems very possible to me that Obamacare will lead to growth in the skilled nursing field. Many traditional med/surg patients can be adequately cared for much more cheaply in a sub-acute facility.

I am a keynesian economist myself, but the formerly unemployed people in my area without any education or trade skills appear to be thrilled to the very core to be earning $12 an hour with benefits. Personally, I find it deplorable that they are going to earn $25K next year while BC/BS earns a projected $400 million, but despite what the tea party conspiracy theorists say, I only got to vote once, lol, and we still have a republican congress. It is what it is. Short of another revolution, I guess we just have to make the best of it, and $12 an hour is better than starving to death by any definition, wouldn't you say?

I don't disagree with you about continuing needs for nurses (we could argue a bit about the likely minimal educational preparation and licensure), and I agree that there is going to be a lot of redistribution of care delivery and services over the next 20 years. I didn't fail to address it because I suspect those nurses are going away or are unimportant. I simply didn't address it because I don't have data to speak on it intelligently and I am not one to just make suppositions and guesses without facts, or regarding things of which I have no first hand knowledge. I speak of what I know, period.

KATRN78 · Nov 15, 2013

I am worried but not because of Obamacare. I am worried and disappointed because the USA is too vapid to socialize healthcare.

Mindful, RN · Nov 16, 2013

...oh please , :cautious:

Overland1, RN · Nov 16, 2013

It will be OK. If you like your job, you can keep your job. Period.

Even though it is a substandard job, you will be allowed to keep it for another year.

jaad · Nov 20, 2013

It's going to be very interesting...to say the least!