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?
I wasn't asking how much is spent per person, which is how I read your reply the first time. I wanted to know how much each person has to pay into the system.
I should have directed my question to the poster as I was really interested to know if someone who was promoting the virtues of the UK system knew all the facts.
My figure is slightly different then yours. The point is that it is true, our tax+premiums come out to be more expensive in most cases. However, if your insurance is through your employer it is subsidized, sometimes greatly. And, most people are now getting subsidized ACA plans. monkeyhq somewhere mentioned they pay $80/month in insurance. She/he would likely be paying much more in the UK. Not to mention, as a nurse, would be making a lot less income.
In the UK one's National Insurance contribution (a deduction from one's paycheck) covers medical care received from the NHS. The actual amount one pays is, to my knowledge, calculated as a percentage of one's wages/salary. A friend told me many years ago that one third of their pay check went towards the NHS.
Nurses in the UK who work for the NHS (the majority of nurses) are eligible to receive an NHS pension, which is a final salary pension scheme that is quite attractive, and an incentive for many people to work for the NHS.
The American Recovery and Reinvestment Act of 2009 (ARRA) commonly referred to as the Stimulus or The Recovery Act, was an economic stimulus package enacted by the 111th United State Congress in February 2009 and signed into law on February 17, 2009, by President, Barack Obama.
Our deductions (or lack there of because we're compliant with Meaningful Use) have nothing to do with the provider's quality of care. I would like to see the algorithm in place to define "good job" versus "bad job" and the correlations of deductions.
The development of the value based purchasing and other elements of the Hitech act started in 2002. The final rules and bill was passed three weeks into Obama's first term. My hospital has been working under many of the value based purchasing rules since 2006. "Value" is determined by things like the incidence of preventable adverse conditions such as central line infections, rate of readmissions for the same condition, adherence to core treatment measures, HCAHPS scores, etc.
Here's a source of various scoring measures and how a "good job" is generally defined:
I really appreciate your survey.. You asked what peoples opinion were. You then appear to be negating what people are saying.. Just exactly what is your agenda in this?
Actually, I have asked for facts. Perhaps you have confused me for someone else?
How do we even know that the A.C.A. is actually what had caused some of these undesirable situations? As we learned in statistics, correlation does not equal causation.
At my hospital, there were a great deal of cost increases in regards to our insurance, well before ObamaCare was supposed to be put into action. We were sent letters saying that these increases were in anticipation of the financial blow that the A.C.A. would cause to our facility. But to me, it sounds like whoever is in charge jumped at the opportunity to save some money and used this as a scapegoat. But, of course, nurses ran around everywhere saying, "Thanks Obama." It all sounded fishy to me...
Of course, it's undeniable that some people will not reap the benefits of the A.C.A., but when deciding if it was a good or bad decision, I think we need to look at the overall effects over some time, not personal anecdotes about good or bad things that happened to occur right around the time it came into effect. Let's give it some time before we decide. I can tell you that this bill was the, without a doubt, saved my dad's life, and he is a man who has worked his whole life. So for that reason, I am grateful for it.
I don't know if it's ACA directly, but medicare has thrown a LOT of road blocks and red tape in their pay out of benefits, which makes it very difficult sometimes to provide the quality of care we would like to in relation to hospice benefits.
Well, my premiums went up $100/month for a $500 higher deductible (from $1000 to $1500) with higher copays and 80/20 coverage instead of 90/10--and that's just for me. Hubby has himself and the kids on his plan (his employer won't cover spouses if spouse has insurance available through their employer) and his went up some too. Regarding patient care, I'm in a clinic setting and I've seen pts cancel appts because their visit would be applied to their deductible and they can't pay it; I've seen many pts have to d/c their allergy shots because they can't pay the new copay charged every week even though it's not an office visit. I've had two (that I know of--front desk handles all this) cancel appts because they were denied for pre-existing condition by their insurance. They did get health coverage in general, but the specific pre-existing condition was NOT covered.
One of my patients in radiation treatment just told me her insurance was changed by the ACA in August from an HMO to a PPO. Her primary doc is now considered "out of network" and the dermatologist she needs to see for a foot rash (unrelated to her cancer) has a wait time of over 6 months for an appointment.
I don't know if it's related to the ACA - maybe, maybe not- but in the past few months census has been so low at all of the facilities with both companies i work for, that I've been cancelled for literally HALF of the shifts I book.
One of my patients in radiation treatment just told me her insurance was changed by the ACA in August from an HMO to a PPO. Her primary doc is now considered "out of network" and the dermatologist she needs to see for a foot rash (unrelated to her cancer) has a wait time of over 6 months for an appointment.
The ACA doesn't change HMO insurance to a PPO. HMO's are still HMO's after Obamacare.
Susie2310
2,121 Posts
In the UK one's National Insurance contribution (a deduction from one's paycheck) covers medical care received from the NHS. The actual amount one pays is, to my knowledge, calculated as a percentage of one's wages/salary. A friend told me many years ago that one third of their pay check went towards the NHS.
Nurses in the UK who work for the NHS (the majority of nurses) are eligible to receive an NHS pension, which is a final salary pension scheme that is quite attractive, and an incentive for many people to work for the NHS.