Obamacare and hospitals

wirehead · Nov 6, 2014

Millions paying less than $100 per month for Obamacare - CBS News
(I was wrong, it's $82/month).
$82 for subsidy-eligible people and $264 for taxpayers for basic coverage with ridiculous deductibles, and don't forget the ridiculous amount your own private health insurance went up as a result of the ACA. I know you realize that in order for people to pay $82 a month, others must pay much higher premiums to cover them, who gets screwed, not the 1%, but the middle class!
Actually even if leave out people who are newly enrolled in medicaid the number of uninsured still dropped. (what good is insurance with a huge in-network deductible it's essentially a catastrophe plan)
There's actually not a nursing shortage, and this seems to contradict something conservatives have been arguing for some time which is that nobody is getting less care because they have insurance. If giving more people insurance is potentially going to strain the system then it doesn't appear that could have been the case. (Well my facility has nurse/patient ratio of 20:1, do you consider that safe practice? I know many other nurses who face the same or worse conditions, so there is absolutely a shortage.
Regardless of that though I disagree that allowing more people to access healthcare is a problem, even if it means we need to figure out how to meet the demand. Should we just leave a portion of the population to suffer so that we don't strain the system? Who should be left out to keep the demand for services manageable?
Who said we should not treat people or deny them access, I'm just saying the demand of the sick is greater than the supply of health care providers, especially primary care physicians and nurses. That's why more PA's and NP's are taking their place.
I for one welcome our new red overlords and actually support repealing obamacare if that's what they're able to do, although I'm curious what I can expect in it's place, maybe you could enlighten me.

The following article has some of the alternatives to what we have now, the ACA should be a hybrid that includes some of the suggestions in the following article:

http://www.foxnews.com/opinion/2014/04/03/why-am-co-sponsoring-save-american-workers-act/

SC_RNDude · Nov 6, 2014

I take it you're referring mainly to this post:
Which still leaves the same questions:
We already have a system where your own money, either from your ACA or regular bank account, pays for costs up until a point then insurance kicks in. You can already buy a catastrophic plan which covers costs exceeding around $13,000 for a family. Is that amount too low? Given that the average household income is around $52,000 a year, I'm not sure it's realistic to argue that they should be paying more than $13,000 a year out of their own pocket in addition to the amount required to cover their insurance for what exceeds that amount.
You can already buy "multi-state" plans and states can also establish compacts under the ACA to establish standardized regulations to ease cross-state insurance plans. How would you change what already exists?
And again, people already pay for services up to a limit and decide how they spend that money, either out of an HSA or regular funds, so what would change?
Unless we're going to change our total healthcare costs, by reducing services, reducing payments, etc, we still have to somehow put the same amount of money into the system. It would be great to say that everyone can just pay less, the problem is that for every person who pays less, someone else has to pay more in order to be able to write the same check for healthcare every year.

No. I was referring to the whole discussion. In fact, let me expedite this discussion and refer back to Mandate; what's the alternative? - pg.4 | allnurses

My reply to your above post would be along the lines of post #44 in the October 2013 discussion.

You would come back with post #49.

Me, well I'll go with post #50.

Then, I bet post #52 would sound good to you.

I like post #54.

You go with #65, then me #68 and #69, etc, etc.

And, now were back to where we started. You claiming conservatives do not have any alternative plans. And then when reminded of one we've discussed several times you say I haven't explained how it's different then what we already have.

pmabraham, BSN, RN · Nov 6, 2014

Good day:

In addition to Obamacare being sold on numerous lies, there's the basic fallacy that health care insurance equates to health care access. Over and over again I've talked to people who now state that thanks to Obamacare, the poor have health care. No; they may have (may being a key word) insurance through Obamacare, but that is not guaranteed access to health care. Why? In a free society, the doctors, hospitals and other providers have every right to state what insurance they will and will not accept.

You already have 214,000 (and growing in number) doctors who have stated they will not accept insurance that is associated with Obamacare. You have top and key hospitals doing the same. The network becomes more and more narrow. In addition, when a person who has insurance through Obamacare actually finds a doctor / hospital to accept the insurance, often times they are hit with out of network charges as the lab work and specialists may not accept the insurance. The deductibles are extremely high, and this will create a financial burden for the poor and middle class. Obamacare, in part because it was sold on lie after lie after lie, solves nothing and just creates problem after problem.

Thank you.

toomuchbaloney · Nov 6, 2014

Republican legislators now have the power to repeal the ACA.

I will watch with interest to see which pieces they remove (like the tax on medical devices and the employer mandate).

It will be a good bit of entertainment and I look forward to hearing them commit to alternative approaches rather than just criticize the law.

mariebailey, MSN, RN · Nov 7, 2014

Has anyone actually experienced Obamacare firsthand? I have. I had some health issues & decided to quit my job/return home to the lower 48 prior to applying for another job. I needed health insurance. It was around the beginning of 2014, so I signed up for Obamacare. I'll admit my premium was high because I signed up for the most expensive, platinum plan available. I needed it because I have a chronic health condition that requires regular visits to a specialist. Not only was I able to see my PCP of choice, but I was also able to see the specialist she recommended under my plan - both required a $15 co-pay. I paid about $40 a month for prescriptions that would have cost me close to $2000/month out of pocket. Obamacare saved me a lot of money when I needed it, & my coverage included a broad network.

LadyFree28, BSN, LPN, RN · Nov 7, 2014

Has anyone actually experienced Obamacare firsthand? I have. I had some health issues & decided to quit my job/return home to the lower 48 prior to applying for another job. I needed health insurance. It was around the beginning of 2014, so I signed up for Obamacare. I'll admit my premium was high because I signed up for the most expensive, platinum plan available. I needed it because I have a chronic health condition that requires regular visits to a specialist. Not only was I able to see my PCP of choice, but I was also able to see the specialist she recommended under my plan - both required a $15 co-pay. I paid about $40 a month for prescriptions that would have cost me close to $2000/month out of pocket. Obamacare saved me a lot of money when I needed it, & my coverage included a broad network.

Thank You for sharing your experience. :yes:

I think that there are going to be many that benefit, some that don't, and in the long run, it will need to be tweaked as well as the benefit of it-because it can't be repealed at this point despite the changes to our legislative branch-twenty years down the road; it may be changed for the better or a single payer system reform?

I'm giving it a wait and see approach.

BlueDevil, DNP · Nov 7, 2014

so obamacare wont have an affect on revenue of hospitals?

Probably not. The only thing different, by the way, between for-profit and not-for-profit health care is the way the accounting is done. Reimbursement is the same. Not-for-profit health care centers often have an agreement to donate services to the community either directly or in the form of research, etc. This is in exchange for tax incentives. It really isn't going to make any big difference to the patients or staff.

BlueDevil, DNP · Nov 7, 2014

Ok, I'll play. I went to my state exchange for the first time today.

You could receive a government tax credit subsidy of up to: $0 per year(which covers 0% of the overall premium)

Amount you pay for the premium:$XX,xxx per year

(which equals 2.5% of your household income and covers 100% of the overall premium)

For example, you could enroll in a Bronze plan for about $X,xxx per year

(which is 1.98% of your household income).

How, by any stretch of the imagination, does 2.5% of our income = expensive? Now, truth be told, we pay less than that for platinum coverage through my wife's employer, but this would not be a hardship.

Not_A_Hat_Person, RN · Nov 8, 2014

You already have 214,000 (and growing in number) doctors who have stated they will not accept insurance that is associated with Obamacare.

Not exactly.

A chain email claimed that more than 214,000 American doctors are "opting-out of Obamacare exchange plans." That is based on a survey of a select group of doctors and even the makers of the survey said it can’t be extrapolated for the entire country. Further, of the doctors responding to the survey, 42 percent said they weren’t participating in marketplace plans because they were never asked to, not because they were "opting out."
The estimate is the result of a flawed methodology and a misreading of survey data. We rate the claim False.

BlueDevil, DNP · Nov 8, 2014

We can't decline insurance purchased on the exchanges, unless we want to decline ALL BC/BS, Aetna, UnitedHealth Group, Humana Group, Cigna Health Group, Metropolitan Life, etc. I don't know about my colleagues, but I cannot afford to refuse to take all of those, lol.

What silly contention.

pmabraham, BSN, RN · Nov 10, 2014

Good day:

Per Obamacare Architect Admits Deceiving Americans to Pass Law (and many other news articles about the same thing that just came out), ObamaCare was passed on lies. You have the prime architect of Obamacare outright stating the American people are stupid. The same guy outright states the law was written so CBO would have a hard time scoring it, and that wealth is redistributed between the healthy to pay for the sick. Yes, the midterms elections were about Obamacare, Obama, and the disastrous policies of the liberals.

Thank you.

Not_A_Hat_Person, RN · Nov 10, 2014

The conservative group American Commitment posted Jonathan Gruber’s remarks, reportedly from an Oct. 17, 2013, event, on YouTube.

So a website run by the right-wing Heritage Foundation ran an opinion piece about the ACA featuring an unverified video posted by a conservative group. Hmmmm.