Obamacare: Should I get out while I still can?

DoGoodThenGo · Jul 19, 2012

Your brilliant governor just opted out and it is going to hurt hospitals big time. Time to get out? Yeah of Texas.[/quote']
My dear you and residents of other states where governors have *said* they will opt out of "Obamacare" have little to fear in the long run.
Medicare/Medicaid reductions in reimbursements are going to happen to *ALL* hospitals regardless of what the state does with OC. Healthcare systems/hospitals in states that opt out will be saddled with less funds on one hand, but no access to the other funds such as increased levels of insured and those on Medicaid on the other. Considering the vast wealth and influence physicans and healthcare systems have on politics one way or another ObamaCare will be rolled out nationally.
Texas in particular has one of the highest levels of uninsured persons in the fifty states. So no matter how much people may hate Obama, they may just swallow all that and take the federal government up on the offer.

AmandaVanGuilder · Nov 9, 2012

I have read through the posts regarding this topic and Ihave to say that as a nursing student, I have often wondered myself aboutObamacares effects on my career. I worked in a hospital for 2 years as areceptionist and often was responsible for going through the clinicaldocumentation. I witnessed the clinical staff being forced to compromise theircare of the patient because the paperwork had become so extensive. There wasn’tenough time during a shift to complete it all. Often staff would stay late,unpaid in order to complete the required documentation for Medicarereimbursement. I noted their dedication to their patients as they tediouslymilled over paperwork and their dedication to the company. Mostly I noted thatthey feared job loss if the reimbursement cuts continued. I am fearful thatObamacare will impose stringent regulations on many hospitals and doctor’soffices in order to keep reimbursement of medical services low, as they have sovery obviously done with Medicare. With all that said, I see the appeal toObamacare. It is very nice to believe that more will benefit from theimplementation, and ultimately it will drive costs down for taxpayers. Bygiving people access to preventative medicine, routine screenings, and thelike, the hope is that these individuals will no longer need to rely on the ERfor their care. This in theory will save hospitals money. My major concern isthat as a nation of individuals we are giving up our freedom of choice when itcomes to the matter of our health. I watched as the Obama administrationpreached that all women should have the right to choose. I firmly endorse thatposition, but am discouraged by the notion that a panel of elected officials inWashington would ultimately have the power to decide my choice anyway underObamacare. I would love for things to be fair, and I would love to believe inguarantees, but history has proven that there are no guarantees in life. I for seeanother bankrupt federal program on our hands in the future. Medicare isalready threatened by the reality of becoming bankrupt. I ask myself where themoney will come from to pay for all of these federal programs. The answerunfortunately is from our paychecks. If approximately half of our countrydoesn't pay taxes now then how can we expect to maintain the extreme cost ofimplementing such a program? As nurses we will see a decrease in our paybecause our taxes are going to go up. We will also see federal caps on ourwages, if the government starts taking over the hospitals in this country. We willalso see a rise in the unemployment rate as private sector health insurancecompanies are forced to close their doors. Although in theory Obamacare seems verynice, it is a wolf in sheep clothing as far as I'm concerned. It defies theconcept of free enterprise that our country was founded on and threatens thevery principles that we as a nation have held so near and dear to our hearts.Free enterprise is what fosters greatness. It requires individuals to improve,and create, and grow. It is what creates new and better medicine, surgeries,and diagnostic testing. Individuals are motivated by a healthy sense ofcompetition to strive for betterment. Irealize that Obamacare will be the law of the land shortly, but I am afraid.For the first time in my life, I am very afraid of the direction this countryis heading in. I do not see people as being undeserving of great healthcarebased on their socioeconomic status, race, ethnicity, or sexual orientation. Ido not favor discrimination of any person and would be ignorant if I said Idid. I also do not see heath care as a privilege, but as a right. I wanteveryone to have access to great medical care, primary prevention, andscreenings. I believe that is right and good for us as a nation. As healthcareprofessionals we should always promote good health for all. I am afraid becauseI see people eating up the entitlements and not questioning it. I see federalprograms going bankrupt and our country facing a fiscal cliff. I do not want toentrust the federal government to take control of my healthcare with that trackrecord. I believe there is a better solution to our problem. At a state level,I believe that we should start making implementations like the ones we saw takeplace in Massachusetts. On a local level, that state has been able to provide stellarhealthcare to its residents. It allows options for every individual, andfreedom of choice is imperative when it comes to matters of health. There isnot a one size fits all when it comes to healthcare coverage. This is myopinion and it is based on the historical failure of federal programs. I do notsee Obamacare offering our nation a way to better itself and I do not for seeit being a good long term solution to our healthcare problems.

d'cm · Nov 9, 2012

So Amanda, to summarize your position: you believe in all the things Obamacare is about, you just don't want to have to pay for it.

mariebailey, MSN, RN · Nov 10, 2012

I know Medicaid is very slow to pay and doesn't reimburse doctors/hospitals much of the actual cost, so won't that trickle down to nurses' pay?...Also, the nursing shortage we have ALREADY is bad enough..so won't Obama's new law just make the problem that much worse by adding more people to a system that already desperately needs more nurses?. I'm also concerned that the quality of care will suffer as well (for the patients).. I really need advice on this...I want to be a nurse, but the uncertainty and the possibility of more work with less pay is not at all attractive...its scary!
So my question is this: Should I go ahead with my plans to go to nursing school despite the unsure future? Or should I get out and find a new rewarding career path to take while I still can? Maybe I can wait awhile to see how things play out first?

There 2 bolded sections of your posts are red flags to me.

If you think it's a bad thing that more people will have access to healthcare, you may not make the best patient advocate as a nurse.
If what you're paid/financial security is a huge factor in determining your career choice, nursing is likely the wrong career path.

Just reflect on your reasons for choosing nursing; it may or may not be for you. Realize that few career paths come with the guarantee of job/financial security at the moment.

SC_RNDude · Nov 10, 2012

There 2 bolded sections of your posts are red flags to me.
If you think it's a bad thing that more people will have access to healthcare, you may not make the best patient advocate as a nurse.
If what you're paid/financial security is a huge factor in determining your career choice, nursing is likely the wrong career path.
Just reflect on your reasons for choosing nursing; it may or may not be for you. Realize that few career paths come with the guarantee of job/financial security at the moment.

Would nursing be the wrong career path because you think it will not provide financial security in the future? That is a concern of mine too. WHy do you think that? I don't know, but would like to know what others think.

You are correct, many jobs do not have gurantees of security. But some are better then others. If you have reasons that nursing is or is not one of the better careers in terms of security, help us out and let us know!

I don't think the poster said that more people having access to healthcare was bad thing. She simply has concerns about Obamacare. I do as well, and I am a great patient advocate.

There are some of us who believe that insurance for more people (Obamacare) does not equal better quality of or better access to healthcare.

mariebailey, MSN, RN · Nov 10, 2012

Would nursing be the wrong career path because you think it will not provide financial security in the future? That is a concern of mine too. WHy do you think that? I don't know, but would like to know what others think.
You are correct, many jobs do not have gurantees of security. But some are better then others. If you have reasons that nursing is or is not one of the better careers in terms of security, help us out and let us know!
I don't think the poster said that more people having access to healthcare was bad thing. She simply has concerns about Obamacare. I do as well, and I am a great patient advocate.
There are some of us who believe that insurance for more people (Obamacare) does not equal better quality of or better access to healthcare.

SC_RNDude, I know your reservations a/b Obamacare. I thought we agreed see how it all plays out (as if it was optional). Those of us who believe in the potential of Obamacare to provide access to care without compromising quality are free to post, so here I am. For the OP, Here's an ANA document put out that outlines the potential impact of the ACA on the nursing workforce. It doesn't address salaries, but it does address quality, the expanding size of the workforce through grants/scholarships, & educational opportunities for nurses.Single Sign On

SC_RNDude · Nov 10, 2012

SC_RNDude, I know your reservations a/b Obamacare. I thought we agreed see how it all plays out (as if it was optional). Those of us who believe in the potential of Obamacare to provide access to care without compromising quality are free to post, so here I am. For the OP, Here's an ANA document put out that outlines the potential impact of the ACA on the nursing workforce. It doesn't address salaries, but it does address quality, the expanding size of the workforce through grants/scholarships, & educational opportunities for nurses.Single Sign On

You career advice implied that if you are unsure about Obamacare then you won't make a very good nurse. As you are free do to so, I am also free to say you are wrong.

I was sincere when I asked you about your opinion on pay and financial security for nurses in the future as that is a concern of mine for which I don't really have an opinion on yet. Maybe I misunderstood your statement. What do you mean when you say, "if what you are paid/financial security is a huge factor in determining your career choice, nursing likely is the wrong career path"?

mariebailey, MSN, RN · Nov 10, 2012

You career advice implied that if you are unsure about Obamacare then you won't make a very good nurse. As you are free do to so, I am also free to say you are wrong.
I was sincere when I asked you about your opinion on pay and financial security for nurses in the future as that is a concern of mine for which I don't really have an opinion on yet. Maybe I misunderstood your statement. What do you mean when you say, "if what you are paid/financial security is a huge factor in determining your career choice, nursing likely is the wrong career path"?

Regarding your first statement - NO, that is not what I stated. Nurses advocate for their patients, so I do have a hard time understanding why a nurse or aspiring nurse would be opposed to legislation that would allow more access to primary & preventive services and prevent denial of coverage d/t pre-existing conditions, among other perks. Regarding the quote at the end: nursing is hard work; many of us work long hours under stressful conditions. Burnout potential is high if you like the job/financial security but dislike the nursing aspect of nursing. That is worth considering.

AmandaVanGuilder · Nov 10, 2012

No, not necessarily. I believe that all Americans should have access to affordble health insurance. In Mass, Romney (while governor of Mass) put together a brilliant plan that allowed for all people to have health insurance. After a year of research, he was able to gain an accurate view of his residents and their needs. By doing so, he was able to provide reform that suited the residents of his state. He developed a plan that would provide for individual residents of the state to purcahse insurance directly and based on their income. The state would provide subsidies according to financial need. The subsidy for the poor was on a sliding scale where the poorest would get a greater percentage of money, and people received less and less of a subsidy as their incomes went up and they were more able to afford it on their own.The monies that would go towards providing these subsidies would come from the funds that were previously designated to pay for people who were receiving a "free ride." What Mr. Romney found through his year long research was that only 20% of the uninsured were truly too poor to buy health insurance. This is a very important point because it had generally been assumed that all the uninsured fell into this category. 40% of the uninsured had the financial means to purchase health insurance but simply refused to do so. The last 40% of the uninsured were people who were able to partially pay for their insurance premiums, but could not afford all of it. As of today recent polls have shown that 84% of Mass residents are in favor of the reform that has gone into place. 99% of the residents of Mass have health insurance, and it has not exceeded it's budget in over 5 years. It still allows Mass residents to choose their plans and therefore retain their freedom and control. I do not endorse a "one size fits all" as Obamacare is and I also do not support a plan that gives the federal government control over such an important issue as my health. I also do not support a plan that will increase tax dollars that I or any other American will have to pay. There is a better way to fix problem and Mr. Romney prooved it. Each state should be responsible for their own. That is the beauty of our unique model as a united nation of states.

PMFB-RN, RN · Nov 10, 2012

You are so correct with number 1. I know people in other states that are telling me that some people that they know personally who are BSNs and boards passers, even those with experience who were laid off are settling as CNAs because of the abundance of nurses. too many people are changing their careers into nursing. I used to believe nursing isnt for everyone, but apparently almost everyone has to be one cause of the recession. Darn economy! lol -sigh
!

*** The poor economy isn't responsible for the glut of nurses. The over supply of nurses was deliberatly brought about by those who stand to gain financialy from a glut of nurses. They used false and self serving (though very effective)propaganda, combined with money lobbied from the federal and state governenments used to expand current or creat new nursing programs. That is what created the ovser supply situation for nurses. The current economy only moved the day of over supply up a few years but it has been building for a long time now.

It didn't happen, it was done to us and to maek matters worse WE as tax payers subisidzed it.

DoGoodThenGo · Nov 11, 2012

Didn't take long post election for the Speaker of the House, John Boehner to issue a statement saying "Obamacare is the law of the land". So like it the thing is done and we all must bear it as best we can.

Not only did Obama win re-election but Democrats held and increased their seats in the Senate in many cases with far more liberal members than before. In short several themes seem to have emerged from the election results including a majority of hte population believes the federal government should be *more* involved affairs such as healthcare.

Physicans as a group in whole according to polls did not support Obama, and now it remains to be seen how they respond to the changed landscape. However two trends that began before the election probably are going to continue; more doctors are going to give up private practice in favour of being "employed" by hospital systems, and physicans who can are going to decline all type and sort of insurance/entitlement programs in favour of cash payment up front. From there patients will have to submitt claims to get their money back.

As it relates to hospitals/healthcare systems the push from the federal government to drive down costs is most certainly going to be felt in one way or another by the nursing service. Hospital/bedside nurses probably looking at yet more paperwork, doing more with less staffing, adjusting to creative and or innovative staffing methods as hospitals seek to fine tune census to nurse ratios.

In many areas of the country there is probably going to be more mergers and or closings of hospitals as the weakest either shut down or absorbed by larger systems. That again continues another trend in healthcare; the larger the system the better able it will be to demand better reimbursement rates from insurance companies and so forth. One foresees hospitals/heathcare systems moving more towards a type of vertical integration system where they are not only providers of healthcare but insurance as well.

Look also for more out sourcing such as what a hospital in Westchester recently pulled off; terminating all employed NAs then contracting out that service to an agency.

Long story short it took generations to build up the private healthcare system in the United States, and many are going to have to be dragged kicking and screaming into any sort of world that even smells of what they associate with "socialised" medicine.

Ineedhelp# · Nov 11, 2012

WF Fqlz