Obama care??

Anna S, RN · Jul 31, 2014

I don't think that more people having access to health care could hurt nursing in any way.

NurseGirl525, ASN, RN · Jul 31, 2014

Yes, it will. It will be a trickle down effect. This is being funded by huge cuts to Medicare which is what most baby boomers are now relying. They are reducing reimbursements to hospitals and doctors which is something that has been going on for years anyway. When you lower rebursments the hospital and doctors offices are no longer profitable. A hospital is a business. Your doctor does not give away his services for free as he shouldn't. So now what happens? The hospitals and docs now stop accepting Medicare which is already happening. ACA reimburses very little also. So where else do they cut? Employees, their biggest expense. I expect in a few years RNs will be making much less then they are now. Jobs will also be scarce.

HarryTheCat, MSN, RN · Jul 31, 2014

I don't think that more people having access to health care could hurt nursing in any way.

The problem with the ACA is that it gives more people access to health insurance, butnot necessarily to health care. Medicare is a great example of just how that works. At 65 everyone can get Medicare, and Part A is completely free. The other parts require a premium. Whoopie!...medical care for everybody! Or maybe not. Medicare reimbursement rates are so low that most docs have to limit the number of Medicare patients that they see. In some areas it is impossible to find a doctor who is willing to take on a new Medicare patient. You may have "coverage", but if no doc is willing to accept it you have no care.

The ACA is heading in the same direction, and we will soon be in a two-tiered medical economy. Those stuck with some form of government coverage (Medicare, Obamacare, Medicaid) will find few options and limited availability of services, while those with the ability to pay out of pocket and those with good private or employer-subsidized coverage will still receive good care. Anyone who didn't sleep through Econ 101 can see it coming. A combination of high deductibles and copays, coupled with low acceptance of reimbursement rates creates a "perfect storm" for a health care system meltdown. The result will be overall less usage, resulting in fewer docs and nurses, and downward pressure on compensation.

pmabraham, BSN, RN · Jul 31, 2014

Good day,

Health care insurance does not equal health care access as the providers do not have to accept the insurance. Even when there is acceptance, there is no guarantee on timeliness. When my wife and I visited Ireland in 2013, we had an excellent tour guide who made it a point of being blunt, honest, and telling us the good and the bad about the country. He shared some of the good aspects of socialism as well as some of the bad including the universal, FREE, healthcare system in Ireland. He shared that anyone who wanted to see a provider timely, and who wanted the best of care was sure to have private insurance. So basically, it was a two tier system -- those who could not afford private insurance who got government care, and those who were able to have private insurance and have better care.

In terms of changes, various news sources are reporting not only limited networks (i.e. LACK of access as health insurance will never equal access in a free country), but also hospitals cutting jobs citing Obamacare. It is understandable that debates can work both ways stating that the hospital management is only using Obamacare as an excuse, but that's just guessing. The real impact (end result) is that jobs are being cut.

On the temporary good side, Obamacare will encourage the growth and acceptance of Nurse Practitioners (NP) and Physician Assistants (PA) as well as increasing their scope of practice/license. In effect, thanks to Obamacare, NPs and PAs will become the more economical choice compared to an MD. However, the way economics works in a free market (US market is not entirely free due to the growing government regulations and the government picking winners and losers, but it is still more free than other countries) is that A) the NPs and PAs will increase their prices as they become more valuable or as valuable as doctors, and B) that NP's and PAs will also go through what MD's are now going through with Obamacare. Which means they might be forced into the same choices that doctors are making -- stick it out hoping Obamacare gets replaced, repealed, etc, accept only cash payments, what insurance to take or not, etc. or drop out and go elsewhere. In turn, should Obamacare continue to be in place and grow, it may eventually expand the scope of practice for RN's (who knows).

The other impact is that our President and those closely around him are very pro abortion, so Obamacare could force more and more nurses and other healthcare providers into a situation where they have to follow their conscious and not participate in an abortion or be fired.

Thank you.

NurseGirl525, ASN, RN · Jul 31, 2014

Pmabraham is exactly right. Right now in my area those on Medicaid go to the ER for everything. If they have have a cold, they go to the ER. They are seen by a NP who determines their care because Medicaid is reimbursed very little. And while there is absolutely nothing wrong with this, let's face it, sometimes a physician is needed. But these lower income people do not have access to doctors. I have thoughts of being an advanced practice nurse someday, but I also know that doctors and nurses think differently. I've been treated by NPs so please don't think I am saying anything negative about them.

There is no such thing as equal medical treatment. I worked as a pharmacy tech years ago for a place that provided to nursing homes. People are divided by what kind of insurance they have. Unless you have Alzheimer's. Then no matter what insurance you have, you are all together. When I would call for clarification or put a new admit in the system I asked for the Medicaid hall, Medicare hall, or private pay hall. That is true of every nursing home we had.

It's sad but the way it is. ACA is not going to change that but just add another tier to the system.

Editorial Team / Admin · Jul 31, 2014

Many people have already posted their thoughts, and may not feel like rehashing those replies. However, the previous threads are a wealth of information, and here's a few that you can look through:

https://allnurses.com/nursing-activism-healthcare/obamacare-nursing-what-756231.html

https://allnurses.com/nursing-activism-healthcare/could-obamacare-cause-853283.html

https://allnurses.com/nursing-activism-healthcare/obamacare-should-i-751029.html

https://allnurses.com/nursing-activism-healthcare/obamacare-mark-beast-750837.html

https://allnurses.com/nurse-practitioners-np/my-obamacare-experience-895976.html

https://allnurses.com/nursing-activism-healthcare/other-side-obamacare-465729.html

These are from the break room, so you may need to log in again (same username and password):

Opinions on Obamacare from healthcare workers? | allnurses

Patriot Nurse explains why Obamacare is a DISASTER - Protect Yourself! . | allnurses

'Obamacare' and your job | allnurses

As you can see, there is already quite a lot of opinions, and these types of threads can be a little heated. I am of the opinion that we can't really know what the future holds. Yes, there have been some positive experiences. Yes, there have been some negative experiences as well. However, the previous system was broken and needed to be fixed. Is this the perfect fix? No, but at least it's an effort over the status quo. Is it going to affect nurses? Absolutely, but how remains to be seen. Much of what has already happened is due to how facilities are reacting, not the law itself (and some of that may be facilities looking to increase profits while not looking bad by blaming ACA).