Obamacare and Nursing.. what do you think?

[OKNurse2be]

I know that I am possibly opening up a can of ugly worms. I hope that in spite of differing opinions, that this thread can remain friendly and a simple exchange of ideas and opinions.

As a beginning nursing student, I am being told that there is this looming nursing shortage and that there is great job security. A little research on my own shows me that in my particular state, there definitely is a decent population of still practicing nurses who are 60 years and older who will be retiring soon, which would open up the way for us who are just getting started. More and more emphasis is also being put on the new healthcare law and how it will open the doors for more people to access medical care which again will increase the need for staffing.

I grew up in a country with a socialistic government, which also includes healthcare for everyone. I have seen how the hospitals are understaffed, and you are lucky if you get to spend 5 minutes with your physician, and you are not in control over which healthcare facility you can go to. I know that the new bill isn't necessarily socialistic, but there are socialistic principles in it.

As a nursing student, I can't help but wonder how this is going to affect my future as a nurse. I know that nurses talk among themselves and things trickle down from above onto the floors. Nothing is going to keep me from becoming a nurse. I am not in it for the money, but rather I feel somehow "called." However, I believe that it's good to be prepared for times ahead so that I can adjust accordingly.

How do you think that Obamacare is going to affect how care is delivered?

By the way, this is NOT a homework assignment of any kind. I am merely looking for for a friendly exchange of ideas and opinions.

[33762FL]

The Affordable Care Act (AKA "Obamacare") is not health care for everyone. In the current system, patients in the hospital are lucky if they spend 5 minutes with the physician, that would not be something new with the ACA. IMO pretty much nothing will change, other than that more people might have insurance rather than just freeload off the system like they've been doing.

[koi310]

Well, the experts predict this impending "job shortage" by 2020, so you'll have to wait almost a decade. Regardless of Obamacare, the healthcare industry is contracting and trying to save money any way it can, including cutting nursing and UAP staffing and increasing nurse-patient ratios.

So you might be able to get a nursing job ten years hence, but you might not like the working conditions at all. JMO.

[VANurse2010]

Please explain to me what is "socialistic" about the ACA. The government isn't taking over any hospitals or insurance companies.

[OKNurse2be]

Please explain to me what is "socialistic" about the ACA. The government isn't taking over any hospitals or insurance companies.

It's not socialistic in the purest form, but government is to a certain extent taking over by mandating that everyone carries health insurance. It's also got the general idea in there that everyone should pay for it, and I keep hearing the word "freeloading" for people who don't want to pay for it. To me it honestly looks like they are taking a socialistic idea and marrying it with a capitalist way of doing things. I am personally totally on the fence whether I like it or not. I agree with that our current system is not working, and I agree that insurance companies should not be able to discriminate against pre-existing conditions. However, I am not sure that requiring that all Americans be insured is a good way to go. Nobody has been able to tell me what it will do to health insurance premiums for instance... Just a lot of uncertainties for me still.

[VANurse2010]

I got news for you - forcing companies to take pre-existing conditions without a mandate will bankrupt them. That's the biggest single reason for the mandate. Last I checked, the government forcing citizens to do something (such as pay taxes or buy insurance) does not constitute a takeover of the means of production or exchange (the definition of socialism).

[Mindful, RN]

:yelclap: Medicare for all... :cheers:

[Overland1, RN]

More like Medicaid for all; I have often heard patients talk about how they will finally get what they want "when Obama takes over healthcare".

[SC_RNDude]

"Medicaid for all" will mean more, not less, inequality when it comes to healthcare. Poor people will simply be at the end of a much longer line for services. Better educated, more affluent people will always have the means to get to the front of the line. They will now have free healthcare services that in the past they would have paid for. Many of them will consume these free services, thus making the line for healthcare longer.

What we need is true health insurance in a true healthcare market. Right now, there isn't a true market or true prices for healthcare. Insurance should be for catastophic circumstances, and people should pay for routine care out of pocket. If people bought policies based on real risk against illness, trauma, etc, insurance companies would be competing for business like they do with car, home, flood, etc. insurance. When you buy car insurance, they will pay you for damages to your car in a accident. They aren't paying for your oil changes, tune-ups, new tires, car washes, etc. They also don't tell you how to repair your car. They give you the value of your damages in cash. Then you decide how the repair will be made and by who. You control your $$$, and this leads to competition, quality, and innovation in the marketplace.

Right now health insurance companies try to enroll healthier people, and try to avoid higher risk people. This is because they have to charge the same for all. This is why many with pre-existing conditions have such a hard time getting covered. If they could charge less for lower risk people, and more for higher risk people, more people would be covered. And if they were competing against each other, they would be motivated to offer the lowest premiums they could.

Insurance companies now pay for many services that many people would pay on their own. People then consume services more often. This makes insurance and healthcare services more expensive for all.

When you are sick, you often have limited choices of who and where and how you will be treated. Limited competition equals less motivation to offer a better product at a better price.

Imagine what would happen if people paid for routine care on their own (you could still use HSA's and FSA's) and when something big happened your insurance company gave you the money to be treated. Then you decided who, what, where, and how you would be treated.

A true market for health insurance and healthcare services would equal better quality and lower healthcare costs for everyone.

[2BRN123]

Honestly, Regardless of what health care plan passes where, who what what how, for better or for worse, if it is not 100% to the benefit of health insurance and pharmaceutical companies, they are going to use it as an excuse to cut access to care, raise premiums and deductibles. It is the nature of business these days. I'm not saying I am or am not in favor of the ACA, but if the government does something that might cost a mega corporation some $$$, they will pass off that cost to you. Because they can.

[Mindful, RN]

... single payer or medicare for all...

[NicuGal, MSN, RN]

And right now, as it is written, people can not take the insurance, pay the "penalty/tax" which may be cheaper in the long run than monthly premiums and then sign up when they get sick, no questions, etc. The ones that suffer are the working poor, and they will still be the ones that are at the bottom. Many insurance companies now require you to be enrolled in certain programs if you have diabetes, HTN, etc to get a lower premium, if you don't meet your goals, your premium goes up the next year. Makes me wonder if this will really come to light with all this "reform".