Could Obamacare cause a shortage in nursing again

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I would really like to know how you believe Obama care will affect the medical field and be honest. I would expect that it would create more jobs but the work would be very tiring. There would be no 3/12 but 4/12 or 3/15 with rooming/bedding at hospital.

Specializes in Pediatrics, Emergency, Trauma.

*** Naw, I don't buy it. 28 cents if every dollar CHARGED is one of the keys here. A hospital can charge ANYTHING it wants. To complain that they only receive 28 cents of every dollar charged is a shell game. What we need to know is how much of their cost did they receive?

Better yet, HOW MUCH they're keeping in their pockets. :yes:

If anything, this will reveal how much these orgs are keeping...time WILL reveal...and the time has COME. :yes:

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Yeah, but who pays for it in the end....

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Specializes in ICU/ER.

some of what you mentioned may very well be true. but i work for a county own hospital and the hospitals finacial records are open to the public. at our last dept meeting the accounting manager laid out everything in a power point presentation in a room full of people including county supervisors, discussing the latest cuts that the hospital might have to implement. its hard to argue your point when all the numbers are in your face and i'm pretty sure the hospital leadership is not cooking the books.

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So it's a war between govt and insurance companies with the hospitals in the middle. Govt says this, insurance companies for the longest time along with hospitals have been cashing in. But govt. pays the bills. The victims are patients and staff who actually do the work. Insurance companies are double dipped in that they also provide . Hospitals are paying the stock owners or nonprofits act like they are owned by stock owners in order to keep up. Govt is giving the beat down.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
some of what you mentioned may very well be true. but i work for a county own hospital and the hospitals finacial records are open to the public. at our last dept meeting the accounting manager laid out everything in a power point presentation in a room full of people including county supervisors, discussing the latest cuts that the hospital might have to implement. its hard to argue your point when all the numbers are in your face and i'm pretty sure the hospital leadership is not cooking the books.

*** I too work in a publical owned hospital whose books are more or less public information. They like to claim they are poor, meanwhile they are spending money, millions in fact, in every direction. Some of our concrete sidwalks had cracks in them. Small crack and not in a place where patients are allowed to go. The side walk wasn't uneven but they ripped it all out and poured new sidwalks. Our very nice parking lot was stripped down to bare dirt and and a new surface applied. Very expensive solid wood doors are being replaced all over the hospital with new solid wood doors. The old door are sitting in the huge dumpster. They are now building an elivated parking structure. We didn't have a shortage of parking as far as I could tell. I know, I know, all those things are from a different pot of money.................

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Specializes in Critical Care.
if this country is not careful and dont start looking at the pitifull riembursements for treatment expenditures that hospitals (particularly in my area of the country) are having to eat there is going to be the disapearing of the small rural community hospitals. how much longer can many of these small facilities continue to get only 28 cents back on every dollar charged and still keep the door open and retain quality staff.

That's sort of a ridiculous argument that hospitals like to use. It's like saying I charge $1,000 an hour for my Nursing services, but only get paid $35 an hour, so I'm losing 97% of what I should be making.

Hospital charges have really no basis in reality and can vary by tens of thousands of dollars between different hospitals in the same city, mainly because there is no rationale to how hospitals come up with these numbers.

Hospitals aren't required to accept medicare patients, they are free to opt out if it's really that bad.

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Better yet, HOW MUCH they're keeping in their pockets. :yes:

If anything, this will reveal how much these orgs are keeping...time WILL reveal...and the time has COME. :yes:

Or they could hide how much they make and hire less nurses. :yes:

and work the already employed ones to death.:no:

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Specializes in Critical care, tele, Medical-Surgical.

Hospital profit margins hit highest level in decades

Community hospitals collectively enjoyed a record-breaking margin in 2010 with more than $52.9 billion in total profits, according to the American Hospital Association.

The 7.2% net margin on $730.9 billion in net revenue, tallied in the 2012 AHA Hospital Statistics guide released last week, was the highest in decades.

The results compare with $34.4 billion in profit in 2009 for a 5% profit margin on $690.5 billion in net revenue. ...

http://www.modernhealthcare.com/article/20120109/MAGAZINE/301099961

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Facilities agreed to take a hit on reimbursement rates on the working theory that fewer uninsured patients would require "charity" or other care for which a hospital either wrote off or was not paid.

A good number of hospital systems are doing from well to very well with new lower reimbursement rates for Medicare/Medicaid, and plans are under foot to continue along in the same manner.

Medicare & Medicaid beds vary by facility. Obviously those with higher percentage of such patients are going to feel the cuts more deeply than those with less exposure. Case in point what we are seeing going on here in NYC; the large "destination" institutions such as NYP, North Shore-LIJ, Sloane Kettering, etc... are all doing well to great. OTOH places like Long Island College Hospital, Interfaith, and others that serve a majority of middle to low income, non-insured, and or federal program covered patients are struggling.

Neither Medicaid nor Medicare were intended to make hospitals "whole" IIRC, but the schemes were designed (among other things) to provide some form of payment for care that otherwise would have been "charity" or not have happened at all for lack of insurance.

As for these cuts leading to a shortage of nurses, I don't buy that at all. What probably may and in some areas is already happening is there will be a consolidation and reorganization of how healthcare is delivered. Smaller community hospitals that are not financially viable will either close or merge with larger systems. There will also be fewer inpatient beds as some of these community hospitals are shut but replaced with various ambulatory and or urgent care facilities. This is what happened with NS-LIJ and the former Saint Vincent's, and Montefiore did with Westchester Medical Centre.

The ACA contains provisions to build on a trend that has been going on for some time; to keep persons out of hospitals unless required, decrease the length of stay for those admitted and keep discharged patients from requiring readmission. What this means in theory is that the United States may finally join much of the Western world with a strong emphasis on community/public health medical and nursing care. So while there may be less need of nurses in hospitals, that does not translate into any sort of "shortage", but that nurses (hopefully) will be working elsewhere.

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Specializes in Pediatrics, Emergency, Trauma.
Or they could hide how much they make and hire less nurses. :yes: and work the already employed ones to death.:no:

Already happening now....the point is to make hospitals accountable for providing care and let US do the "business" of nursing the RIGHT way. :blink:

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Specializes in Management, Med/Surg, Clinical Trainer.
Eight percent of nurses are Democrats. No one else to blame for Obamacare except for the people who voted for it.

Coincidentally, about 80% of prison inmates are ALSO democrat.

8% of nurses are democrats. I thought it would have been many more than that.

80% of prison inmates are democrats. I believe that, but I was not aware they were allowed to vote.

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Specializes in Management, Med/Surg, Clinical Trainer.

I believe that the big winner in all of this will be nurse practitioners. There will be a need for more primary healthcare providers.

I agree that NPs will see an increase in value, but questions remain: will they be paid what they are worth, and will the nursing schools open the doors to allow more training for NPs. So far I am not seeing either.

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