How will the new healthcare law in 2014 NOT create more jobs?

2011NursingStudent · Jan 30, 2011

Providers won't get paid as much, so they'll still be strapped for cash. Besides that, states don't have the money to pay their Medicaid bills now (at least in IL/CA, and some other states), and are deferring payments to providers, so add that many more people to what equates to Medicaid, and its unlikely the bills are going to get paid. That's why states are suing and saying, look, you can't do this, we don't have the money...

I think the real solution is to get the # of jobs back up (maybe put some restrictions in place to make it less favorable to send jobs to India), so that people have jobs & decent insurance.

I have a personal insurance plan from BCBS now, so if I were to go to the hospital, the hospital would get their full premium, not a Medicaid rate. When that plan comes out, it might be cheaper for me to jump on that Medicaid type insurance bandwagon, then a hospital would only get a Medicaid rate. They'll just be making that much less per patient.

Yosemite, RN, ASN, EMT-I · Jan 30, 2011

Answer: see previous poster. Also, healthcare is a business. Businesses exist to make a profit. No profit? No business. Current philosophy in business: do more with less.

As socialized medicine takes over, states will go bankrupt (or something similar). There will be more jobs, but more jobs for unlicensed and "certified" providers. Physicians will have more clients, much less pay per client or a straight salary with ever growing pressure to see more clients. Less RN's, more nurse practicioners with ever growing pressure to see more clients. Less RN's more "med techs" and CNA's. RN's will see even more part-time positions, per diem positions, few full time ones.

Think a shift is busy now? Just wait... remember: "Do more with less." As the economy spirals even further, jobs we'd have quit due to client safety issues and nursing liability will become more the norm. "Standards of care" will change, likely degrade to meet the challenge of providing some level of care to virtually everyone as funding for almost everything by the then near non-existent middle class will dry up. The only question for me is: how long until this occurs? 5 years? 10? It IS coming.

Trekfan · Jan 30, 2011

The problem to me seems to be all the high prices . Case in point a 15 min. office visit cost $ 475.00 just to see the doc . I just got a bill for another office visit I went to and found I was charged $150.00 for them to do an I /o Cath in the office . And there are so many more $2000.00 for an MRI by the way that was noncovered bill. ,$1694.00 for a foley to be put in in the ER ,

And so on . This is just nuts and then you have suppliers milking medicare it makes me sick .

Zookeeper3 · Jan 30, 2011

Now I'm a touch burnt out so take that as you will... with the health care law, not completely posted in your response... medicaid/medicare... reimbursement will be proactively driven upon patient satisfaction scores.

You show up with sniffles... 4 gunshot wounds and 2 codes come in.. you wait 9 hours to be seen for something at 5pm... or 8am could have been handled with a regular doc.. that you don't have.. you're ticked that you can't get blankets, a boxed lunch for you and 12 family members... can't get the dilaudid IV push fast that your asking for as the ER doc perscribes Motrin that you should have bought over the counter before buying your smokes and doing your nails... then you're discharged completely ticked off at the wait only to be given a motrin script.....

and you send in a survey that blasts the staff out of the water... and yes... that affects our reimbursement for medical equiptment, staff, pay, bonuses.

So now because we didn't feed the herd, get you back before the active MI and sent you home with a script that medicaid would have paid for but others pay out of pocket... you have now...

Denied reimbursement to us, we'll loose$$, our ability to pay OT is now gone... so fewer nurses are out there. You don't pay.. so our facility lacks more $$ to staff, so we're shorter.. and the wait times are longer and those that need to been seen quick can't... so we get more negative poll responses... the budget is cut tighter.. we have less staff to care for you...

This is not about ratios's but the bulk of the bill that uses "responses" that if we don't score well,,,, we're cut... keep abusing the system, it will keep being cut and there are NO FUNDS TO HIRE

Zookeeper3 · Jan 30, 2011

I've been reading a couple of comments in which some people are saying that even with the new healthcare law (in the United States-2014), there still won't be that many jobs for nurses (in the future). I don't quite see how, since more people will get access to it, and this should increase the need for nurses, with more patients. I have read the outline for the proposed healthcare law, and it surely does seem like many more people will get healthcare. Am I missing something here?

yep the real health care world... start reading up on it if you intent for it to be your future.. you are mistaken.

anon695 · Jan 30, 2011

I think it will be neutral - no significant job gains or losses. The healthcare law isn't about 'socialized medicine' because there is no public option. We will see a lot more people with medicare because of the aging baby boomers, but we know that would happen eventually (it has nothing to do with the new law). For the rest of us too young for medicare, all the law is is a requirement that we buy private insurance. The private insurance we have to buy is from the exact same for-profit companies we've been using for decades (Aetna, Oxford/United, Cigna, etc) so there is no change here.

silentRN · Jan 30, 2011

the only thing that this health care bill changed was now everyone is mandated to get insurance or pay a fine at tax season; or if you meet the requirements...you get subsidized and don't have to pay for insurance. So now, 40 million more people will be on Medicaid...our country is so broke that it's not even funny anymore. We are given tax returns and welfare checks with money that doesn't even exist. The money that the US government is handing out to programs and Medicare and the such, doesn't even exist...we are that broke as a nation. Gas prices are rising because the dollar is losing buying power, not because of demand. Soon, we will all experience this economic mess at a personal level. That is just my own opinion.

stefanyjoy · Jan 30, 2011

Ok, to answer your question.... sort of...

I work for a large private health insurer to process claims. Let's take a standard office visit for example... The doctor will bill about $130 to the insurance, and the insurance will reimburse about $80, and the provider is contracted to write off the rest.

However.. when I have to deal with Medicaid claims, the physician is reimbursed about $11 and has to write off the rest. Labs are reimbursed pennies.

So, more, if not all, patients who have government-imposed reimbursement rates, which I am assuming will be along the lines of what Medicaid reimburses.

Medicare's reimbursement rate is significantly better, a lot of the time even better than the large private insurance I work for, so it would really depend on how the government would set up the reimbursement rates -- like Medicaid (Lord help us) or like Medicare (there goes my paycheck).

Argo · Jan 30, 2011

they should just keep all the earned income that they plan to dole out to the poor people every year that already soak up government monies in medicaid/welfare/foodstamps. If they kept that money it would likely cut our deficit in half..... Why keep feeding these people green? So they can go out and get a new lcd tv? The business sense of the country is pretty stupid all together, not just health care.... There are too many people with their hands in the piles.... too many lobbiests that are allowed to run rampant and pay off these politicians so they can pass whatever legislation that drug companies, insurance companies or whoever wants to be passed.....

IMO, If Obama truely wanted to make a CHANGE he would have truely socialized medicine and made 3 or 4 different plans available to the public at a very reasonable fee through tax. Opt into a plan and your paycheck is a little smaller, but you get to pick your level of how much smaller and how great of coverage you get. Still leave private insurance as an option, not a mandate. All these new laws is going to do is make the private insurance companies a little richer and make the country poorer.

To be honest, private insurance doesnt reimburse all that much better than gov programs currently in place.

Southern Magnolia · Jan 30, 2011

The problem to me seems to be all the high prices . Case in point a 15 min. office visit cost $ 475.00 just to see the doc . I just got a bill for another office visit I went to and found I was charged $150.00 for them to do an I /o Cath in the office . And there are so many more $2000.00 for an MRI by the way that was noncovered bill. ,$1694.00 for a foley to be put in in the ER ,
And so on . This is just nuts and then you have suppliers milking medicare it makes me sick .

But look at what the provider gets compared to what is charged. I just got a hospital bill for an ER visit from my son. $600 was charged, $350 was written off, $225 was paid by insurance, and $25 was paid by me. So I suspect that $350 or so is what should have been charged but the hospitals bump up the fees to make up for what they are contracted to write off with insurance.

metal_m0nk, BSN, RN · Jan 30, 2011

Honestly, we can speculate all we like, but we won't know until we're there.