I'm scheduled to start in a private ED hospital next month. I started at a VA on a PCU unit as a new grad, but I feel like I'm depriving myself of the experience I desire.
As I consider transitioning from a highly political, but stable federal hospital (VA) to a private hospital in order to gain the ED experience that I desire (a broader pt population-not just older vets in for pain med refills and jock itch), I ask myself how the ACA has affected your employer (hospital, school, prison, etc.). Have budgets been cut? Have layoffs taken place (specifically nurses being laid off)? Are you called off less or more? Have PRN positions been eliminated or increased? Is agency/travel used more? Have your benefits been affected? Have your employers anticipated any forthcoming changes?
Here are some facts for you about the healthcare system in the US when compared to other nations. Now I have to go take care of sick people, so I am out....
my health insurance through work has decreased in quality (less coverage, higher deductible, and max out of pocket) but the premiums havent gone up too much. This is due to the "cadillac tax" my company would face if they had kept the better plans.
our hospital has had a high census for months but Im not sure if that is from these new changes.
My hospital sent out a report some time back stating that they believe their insurance carrier for employees would be grandfathered in for the ACA.
I pay under $40 a month for my husband and zero for my monthly copay. Drs visits are $20 a pop and ER visits are $100.
I have never had difficulty with access or referrals to a provider or specialist.
I would love to be called off once in a while, but such is not the case. We are generally always full and frequently cannot downgrade patients out of the ICU because the general medical floors are full.
my health insurance through work has decreased in quality (less coverage, higher deductible, and max out of pocket) but the premiums havent gone up too much. This is due to the "cadillac tax" my company would face if they had kept the better plans.
our hospital has had a high census for months but Im not sure if that is from these new changes.
Maybe I have read this wrong, but this post doesn't make sense to me. How would a company suffer a "Cadillac tax" for offering better insurance coverage at lower prices? The whole idea of the ACA was to get rid of " junk insurance" and offer a good insurance at a better price. Not a lower price than the junk insurance, but a better price than the quality insurance that should have been offered.
one summary on it. google it for further information.
im all for everybody having access to healthcare but im not for everybody being forced to have equal healthcare unless it is superior. this bringing down the haves to meet in the middle w/the current have nots is, in my eyes, a form of socialism.
In general there are simpler ways to do this (insurance), but if we're going to use this system the cadillac tax seems pretty reasonable.
The cadillac tax is a tax on high cost plans, for family plans it's a plan more than $27,500. One reason for this is that such a plan likely has little to any out-of-pocket costs for the consumer. The argument (which is a common conservative argument) is that when an insurance plan covers every single dollar then there's no incentive for the consumer to spend their money wisely; to be a good consumer. The idea is that insurance should only cover whatever amount over the course of a year beyond what a family can pay in out-of-pocket costs.
Another reason is that it puts a cap on the tax break (subsidy) that people receive when getting a plan through their employer. Someone who gets their plan through their employer is getting the value of that plan as tax free income, for a $27,500 plan that's about $5,000 in tax break/subsidy. When people don't get their insurance through their employer, they pay tax on the income they are using to buy the plan, so instead they get a tax break/subsidy when they purchase the plan, which typically doesn't exceed about $5-6,000. The cadillac tax is not on the entire value of the plan, it is on the amount that exceeds $27,000. So an employee who receives a plan worth $29,000 would pay about $600 in tax on that $29k in income, which is still a pretty good deal.
In general there are simpler ways to do this (insurance), but if we're going to use this system the cadillac tax seems pretty reasonable.
The cadillac tax is a tax on high cost plans, for family plans it's a plan more than $27,500. One reason for this is that such a plan likely has little to any out-of-pocket costs for the consumer. The argument (which is a common conservative argument) is that when an insurance plan covers every single dollar then there's no incentive for the consumer to spend their money wisely; to be a good consumer. The idea is that insurance should only cover whatever amount over the course of a year beyond what a family can pay in out-of-pocket costs.
Another reason is that it puts a cap on the tax break (subsidy) that people receive when getting a plan through their employer. Someone who gets their plan through their employer is getting the value of that plan as tax free income, for a $27,500 plan that's about $5,000 in tax break/subsidy. When people don't get their insurance through their employer, they pay tax on the income they are using to buy the plan, so instead they get a tax break/subsidy when they purchase the plan, which typically doesn't exceed about $5-6,000. The cadillac tax is not on the entire value of the plan, it is on the amount that exceeds $27,000. So an employee who receives a plan worth $29,000 would pay about $600 in tax on that $29k in income, which is still a pretty good deal.
Thank you. I had heard of the term Cadillac tax, but had never taken the time to understand what it means in context. This makes the original post clearer now.
You did not use care in reading my statement. I buy my insurance through the ACA marketplace exchange. I am not covered under an employer plan. I had no coverage until this year when the ACA became reality.
Explain to me, exactly, how the quality of care will suffer? You have no data to support that theory. Millions of Americans now are receiving care.
Explain to me how the UK system--the #1 in the free world--manages to provide healthcare for all and beats the U.S. in all categories of care (including quality), if a reduction in profit is such a killer to the industry and innovation? Nearly all European nations best the U.S. in quality and affordability.
On one thing I will agree, there are some even better options than the ACA. It is called Universal HC. But the ACA is better than where we were, and a step in the right direction.
If I feel like arguing with a tree, I will respond more fully when I wake. In my opinion, the most forceful statements against the ACA that actually take the time to mention "Obama" come from those who are deeply rooted in anti-Obama propaganda, no matter the truth of an issue or policy. Not my first rodeo, and I know how this usually rolls with one so deep in their political propaganda that they refuse to recognize evidence they know to be logical and true. Release politicizing the issue. When I speak positively of the ACA and its affect in my state and on my life, I don't say "oh, thank you, Obama my President". But if one doesn't agree with the ACA just because they are anti-Obama, they almost always throw in the name.
Bed now.
You are correct, I misunderstood your statement regarding work and insurance. And, I assumed your current employer offered health insurance. My apologies.
I did say that quality would suffer was just my opinion. That is based on things I've read that were written by healthcare economists, not politicians.
So, when you say that people are now more compliant with meds, and that the ACA is a "dream" for your state, and a "godsend" to the healthcare profession, do you have the data to back that up? You are speaking for your whole state, and the healthcare profession, so I'm assuming those statements reflect more then just your opinion.
I just love the thought that those who disagree with Obama's policies could only possibly have those beliefs because they have been brainwashed by the "anti-Obama propaganda". I've grown tiresome of arguing against that. However, I do find it laughable that now this thought comes from someone who calls the ACA a "dream" and "godsend", not for themselves, but for their whole state and profession.
The cadillac tax is a tax on high cost plans, for family plans it's a plan more than $27,500. One reason for this is that such a plan likely has little to any out-of-pocket costs for the consumer. The argument (which is a common conservative argument) is that when an insurance plan covers every single dollar then there's no incentive for the consumer to spend their money wisely; to be a good consumer. The idea is that insurance should only cover whatever amount over the course of a year beyond what a family can pay in out-of-pocket costs.
I wonder what the incentive will be to be a "good consumer" when we go to a single-payer system?
Explain to me how the UK system--the #1 in the free world--manages to provide healthcare for all and beats the U.S. in all categories of care (including quality), if a reduction in profit is such a killer to the industry and innovation? Nearly all European nations best the U.S. in quality and affordability.
Do you not believe that the healthcare in the UK has benefited from innovations brought about by U.S. profit-seeking companies?
Im not gonna lie, when it comes to anything involving money, im pretty clueless. However, the argument that came from our ceo when our new health care plans were announced, was that if they did not drop the great coverage we had, by some year in the future, our company would be fined millions of dollars.
Sure maybe im not a great healthcare consumer because currently i dont have to worry about my costs if i were to get truly sick like with cancer. i just had a mammogram done along w/drs visit and labs and my out of pocket costs were less than 200.00. but tell me this, how does state aid then help the poor become good healthcare consumers? They have no out of pocket costs. And before i get flamed i would just like to say that i am a big fan of medicaid programs and wish they would be increased so that more people can have that kind of insurance.
the last thing one needs when they get sick is to worry about costs of anything.
Regarding the UK health system, I read that according to one study, the UK came first out of eleven countries with respect to access to care and efficiency of care delivery, in eight out of eleven measures of care. Unfortunately, and significantly, where they didn't score well was on keeping people alive through receiving prompt and effective care, where I read they came in at number ten out of eleven. This data is borne out in the experiences of some of my family members who live in the UK. Some of them have experienced literally years of waiting to be diagnosed and treated by specialists. In the meantime, they have suffered irreversible serious medical consequences. They also have experienced their records being "lost" on multiple occasions, experienced specialists with whom they have appointments scheduled "relocating" suddenly without notice to another part of the world, and experienced infections after surgery that many months later they are still waiting for treatment for.
The UK is a great system in that everyone has access to care. Unfortunately, if you need timely, effective care for more expensive health problems, you may not be assured of receiving such care.
However, in the US, not everyone has access to care, let alone timely, effective care.
In the US not everyone has access to medical care or to quality care. This needs to be remedied. The ACA is a good start; not perfect by any means, but it has ensured access to medical care for many people who could not obtain medical insurance at any price due to pre-existing medical conditions. The ACA has improved the quality of insurance plans and thus improved the quality of medical care provided for many people. How various states have implemented the ACA has of course contributed to good or bad experiences with receiving medical care. Because of the ACA, people do not have to be concerned with having their insurance policy cancelled if they become ill, or of being denied coverage because of pre-existing illnesses, or of reaching the maximum amount their insurance plan will pay for and then being without coverage, or of finding out that their insurance policy didn't really cover them for serious illness.
monkeyhq
242 Posts
Here are some facts for you about the healthcare system in the US when compared to other nations. Now I have to go take care of sick people, so I am out....
http://www.independent.co.uk/incoming/article9542817.ece/alternates/w1024/Davis_Mirror_2014_ES1_for_web.jpg