It could be coming another round of medicaid/medicare cuts

[drmorton2b]

Medicaid reimbursements and Medicare reimbursements look as if they will get even lower! The debt ceiling plan may cause Medicaid to be mostly funded by the states and more cuts to Medicare.

I doubt the sky is falling but it's pretty close.....Does anyone know of another time in Nursing history cuts were this bad?

Keep in mind the plan needs to be ironed out by the house and senate but either way their will probably be more Medicare and medicaid cuts resulting in more job problems for nurses in the forms of hiring freezes and lay offs.

And to think the NNU and Mass Nurses Association supported Obamacare which cut $500 Million from Medicare over the next 10 years. LTC and Homecare will be hit hard. Hospitals that are safety net hospitals or are located to close to other hospitals will probably close.

I'm staying where I am at as long as possible and possibly thinking about a back-up career.

I recall something similar with Medicare or Medicaid cuts happening in 2004ish with Bush and some LTC s closed mostly ones in low income areas and or had to do major facility updates.

The other huge issue is Medicaid it does not pay enough and if the states have to pay more it will spell disaster.

On the other hand things never seem as bad but then again people thought Obamacare would never pass.

[xtxrn, ASN, RN]

When PPS started (back in 1998 or 1999), it was a big shock, and a lot of facilities shut down. I started doing MDSs at the facility (had done them years earlier when it was all done in hard copy and a pen- lol) where I'd been working the floor.

I'm on Medicare, for disability, and plain Med A and B don't come near to covering costs. I pay 400.00/month for premiums for part B, part D, and a supplement high enough to cover all co-pays. A couple of years ago, I had to file bankruptcy, JUST for medical bills- no "fun" stuff/shopping....I was mortified, but providers would NOT work with me. I had a huge spenddown for medicaid (basically a monthly deductible) that didn't allow for rent, food, utilities, or the tank of gas I get every 4 MONTHS.

I haven't heard about what all they plan to cut now. With baby boomers getting older, the politicians who hope to be re-elected need to watch the demographics of their constituency.

Pay billions to terrorist countries, but throw our own under the bus. I'm all for paying what I can- and am thankful I can get the highest supplement policy I can...but the people who are already barely eating every day, it's going to be really bad. And the SNF/LTC communities are going to get punched again.

[xtxrn, ASN, RN]

Obamacare has cost me more (what's been implemented) and provided less- but those of us on Medicare will never "count" like 'regular' people....forgetting that we did work for years and paid into the system...

[Art_Vandelay]

The problem is this: unfortunately, Medicare cuts as being used as a bargaining tool in order for Republicans to agree to allow tax breaks for the wealthy to expire. (Our economy is crap, but tax cuts for our wealthiest citizens continue.) The truth is that Obama is, and always has been, for increasing healthcare coverage, not decreasing it. That being said, Congress is full of millionaires who do not need government funding for healthcare coverage.

From the Washington Post,

"That would represent a major legislative achievement, but it would also put Obama and GOP leaders at odds with major factions of their own parties. While Democrats would be asked to cut social-safety-net programs, Republicans would be asked to raise taxes, perhaps by letting tax breaks for the nation’s wealthiest households expire on schedule at the end of next year."

Here is the link to the full article:

http://www.washingtonpost.com/business/economy/in-debt-talks-obama-offers-social-security-cuts/2011/07/06/gIQA2sFO1H_story.html

Our country is so divided, and healthcare continues to suffer as a result.

[xtxrn, ASN, RN]

Yeah, it's sad, and like the saying goes- "divided we fall"...... but are too blind to see it coming.

[ckh23, BSN, RN]

I always wonder if these topics would be an issue if politicians had to participate in social security and medicare.

[xtxrn, ASN, RN]

How true. It's easy for them to sit in their offices and tick off things on a list to get rid of, without having any clue about what REAL people go through.....one of the nursing homes I worked at had a lot of Medicaid residents. Their soc sec checks (minus the 50 bucks or so- in the late 90s that they got to keep) were often only 300-400 bucks/month since they retired back in the 70s or sometimes earlier. They had to pay that to the facility, and Medicaid would cover whatever they decided was the rate.

I've had heated arguments with people about "those people should have planned better"... my question was always "how much planning could you do with 2.00/hour and 4 kids to feed?"....these were hard working people who never dreamed of ending up in LTC- and they did the best they could with the medical problems they never anticipated either.

[gatormommy]

There can only be two outcomes to the current debt distaster: we either keep going down our current path and eventually become a socialist country with sup-par healthcare and have our freedoms taken away, or we let the bottom fall out, which will cause a lot of acute money pain, but reset the economy and start over.

We are an entitlement country now--most people are paid by the government or are on the dole, whether working or not. How can we sustain this type of economy? If the government keeps increasing taxes on the 52% of the country that actually pays all the taxes, where does the money come from when the tax payer is eventually forced on to the government dole and has no more to give?

Let's start writing the people on the 'Hill,' who are supposed to be representing us and start asking questions and holding them accountable. Why do we as American citizens have such small voices? We're gonna have to scream if we want the 'Hill' to here us!!!!

Myth: We own a business so we are wealthy. Our taxes are raised all the time. Guess what? When tax after tax after tax is imposed on small, small, small businesses, growth stops. We've closed stores and don't hire anymore, we can't afford the payroll taxes. This is a huge problem seeing how the private sector income is the what fuels economy stability.

Why does everyone say, "We need to cut spending, but don't cut the program I like." I say pay what's necessary..........everything else is on the table. Isn't that how we run our own households? It's called sticking to a budget.

[MickeyTong]

[gatormommy]

@MickeyTong-

Great quote. A 'republic' is how it was supposed to be. Each state was supposed to be governed independently, by governors. The Federal Governent's only job was to protect us from outside invasion, not control every aspect of our lives.

We are exactly what John Adams feared--a democracy--mob rule.

[heron, ASN, RN]

There can only be two outcomes to the current debt distaster: we either keep going down our current path and eventually become a socialist country with sup-par healthcare and have our freedoms taken away, or we let the bottom fall out, which will cause a lot of acute money pain, but reset the economy and start over.

We are an entitlement country now--most people are paid by the government or are on the dole, whether working or not. How can we sustain this type of economy? If the government keeps increasing taxes on the 52% of the country that actually pays all the taxes, where does the money come from when the tax payer is eventually forced on to the government dole and has no more to give?

Let's start writing the people on the 'Hill,' who are supposed to be representing us and start asking questions and holding them accountable. Why do we as American citizens have such small voices? We're gonna have to scream if we want the 'Hill' to here us!!!!

Myth: We own a business so we are wealthy. Our taxes are raised all the time. Guess what? When tax after tax after tax is imposed on small, small, small businesses, growth stops. We've closed stores and don't hire anymore, we can't afford the payroll taxes. This is a huge problem seeing how the private sector income is the what fuels economy stability.

Why does everyone say, "We need to cut spending, but don't cut the program I like." I say pay what's necessary..........everything else is on the table. Isn't that how we run our own households? It's called sticking to a budget.

Myth: that the interests of small, proprietary businesses are the same as those of large, publicly traded national and multinational corporations ... whose record profits don't indicate a great deal of distress over this or any other crisis.

We've made the mistake of assuming that capitalism=free enterprise and honest competition. It doesn't.

The current approach pretty much ensures that revenues will drop across the board = reductions in force = more people desperate for work = dropping wages = dropping consumer spending.

Small businesses don't have a chance ... leaving the field to the big corporations who will pay as little as possible and charge as much as possible. Kind of like what happened when all those US corporations moved manufacturing to the Third World.

Eliminate the "social safety nets" and, voila! ... a captive labor force that has no choice but to accept whatever the corporations choose to dish out.

[MickeyTong]

@MickeyTong-

Great quote. A 'republic' is how it was supposed to be. Each state was supposed to be governed independently, by governors. The Federal Governent's only job was to protect us from outside invasion, not control every aspect of our lives.

We are exactly what John Adams feared--a democracy--mob rule.

Well, no......Government of the People, by the Top 1%, for the Top 1%.

Remember this guy?