Obamacare? what are your thoughts

toomuchbaloney · Apr 23, 2014

Keep in mind that insurance companies aren't just "divvying up the high costs," they are also siphoning big profits off the top. A "medicare for all" model would at least take the "for-proft" (re: the insurance companies) piece out of the equation.

But those who value capitalism over all else are not happy about that, which is why we are now implementing the conservative concept of the "individual mandate" in marketplace exchanges.

Delicate Flower · Apr 23, 2014

Muno, you may be right that I am complaining about the wrong thing in mentioning the high costs of Obamacare, when I should be talking about the outrageous cost of healthcare in general. I never shopped for non-employer sponsored insurance before this, so I can't really argue against that point.

What I have noticed anecdotally in a couple of different states where I have worked in the last 2-3 years is something like an arms race of hospitals building and remodeling and adding amenities and perks like extra flat screens, 24 hour room service, huge hospital rooms with extra space for families, etc. While I think these things are great for patients, of course, I'm not sure it's the best use of limited healthcare dollars. I'm sure it's at least in part related to the patient satisfaction/reimbursement link.

I don't know if there is an alternative to the plan i mentioned for non-Christians. I think part of why that particular plan is working and costs are relatively low is they can mandate 1)non-smokers only, and 2)alcohol consumption very moderate according to Biblical principles. While I don't necessarily agree with those particular ideals (though as a non smoker, non drinker I really don't care too much) I do feel like it helps keep costs low.

DoGoodThenGo · Apr 23, 2014

Muno, you may be right that I am complaining about the wrong thing in mentioning the high costs of Obamacare, when I should be talking about the outrageous cost of healthcare in general. I never shopped for non-employer sponsored insurance before this, so I can't really argue against that point.
What I have noticed anecdotally in a couple of different states where I have worked in the last 2-3 years is something like an arms race of hospitals building and remodeling and adding amenities and perks like extra flat screens, 24 hour room service, huge hospital rooms with extra space for families, etc. While I think these things are great for patients, of course, I'm not sure it's the best use of limited healthcare dollars. I'm sure it's at least in part related to the patient satisfaction/reimbursement link.
I don't know if there is an alternative to the plan i mentioned for non-Christians. I think part of why that particular plan is working and costs are relatively low is they can mandate 1)non-smokers only, and 2)alcohol consumption very moderate according to Biblical principles. While I don't necessarily agree with those particular ideals (though as a non smoker, non drinker I really don't care too much) I do feel like it helps keep costs low.

Many hospitals are locked in an "arms race" if you will for patients (especially those with deep pockets and or excellent insurance) in part in reaction to how healthcare is changing in this country.

Leaving aside sudden acute or major health episodes patients can and often do choose where to be admitted based upon several criteria. Part of this is related to the "customer service" model that has only been growing over the past few years. Patients are now "clients" and want not only top shelf medical care but surroundings and comforts that sound more like a spa or four star hotel. Private rooms, large flat screen televisions with Internet access, suites or beds for family members, plush bathrooms, etc.... The hospitals who hope to compete for such patients have no choice but to adapt or perish.

Case in point here in NYC many great hospitals such as Saint Vincent's and Long Island College have closed or are closing even though their locations are some of the most wealthy in the City. Indeed in The Village where Saint Vincent's was housing costs more per square foot basis than on the Upper Eastside. Problem is that the wealthy and well heeled would not go to these hospitals no matter how great the care. Far as many are/were concerned "charity hospitals are what they are", and they weren't going there if it could be helped.

MunoRN, RN · Apr 23, 2014

Muno, you may be right that I am complaining about the wrong thing in mentioning the high costs of Obamacare, when I should be talking about the outrageous cost of healthcare in general. I never shopped for non-employer sponsored insurance before this, so I can't really argue against that point.
What I have noticed anecdotally in a couple of different states where I have worked in the last 2-3 years is something like an arms race of hospitals building and remodeling and adding amenities and perks like extra flat screens, 24 hour room service, huge hospital rooms with extra space for families, etc. While I think these things are great for patients, of course, I'm not sure it's the best use of limited healthcare dollars. I'm sure it's at least in part related to the patient satisfaction/reimbursement link.

You're referring to HCAHPS which actually pre-dates Obamacare, the initial HCAHPS implementation was in 2006. But I do agree, the perks and frill that are used in the private, for-profit market to get an edge add to the costs of healthcare. Medicare Advantage is a prime example. Conservatives used Medicare Advantage as an example of what we were missing without privatized medicare, since advantage plans offered many perks to lure customers, as it turns out these perks and other inefficiencies of a for-profit system added about 12% to the cost of medicare plans. The conservative alternative to Obamacare is even more privatization and all of the costs that go with it.

I don't know if there is an alternative to the plan i mentioned for non-Christians. I think part of why that particular plan is working and costs are relatively low is they can mandate 1)non-smokers only, and 2)alcohol consumption very moderate according to Biblical principles. While I don't necessarily agree with those particular ideals (though as a non smoker, non drinker I really don't care too much) I do feel like it helps keep costs low.

The first thing to keep in mind about these plans is that they are not insurance; there are no coverage requirements, they are not regulated, and they can limit claims as they see fit. They are similar to medicare in that they follow the basic idea that we should just pool our healthcare costs and then divvy up the total with as little additional cost as possible, except that medicare has rules that protect the consumers.

These plans are cheaper and it's important to understand why; they are limited risk pools. Consumers using these plans still carry a very large burden of their costs. Although if they get too big the group can simply chose to no longer cover them, at which point they can sign up for a private insurance plan and start collecting immediately on large claims paid out of a plan that they have never paid into until now.

The problem with anyone saying they only want to share in the costs of healthy people is that the unhealthy people can't cover their own costs, so until we're actually willing to say we're just going to leave the unhealthy people to die, it's not a system that translates to overall health insurance. It's basically just a way to make it legal to screw everyone else.

klone, MSN, RN · Apr 23, 2014

as it stands now a majority of the voting population doesn't favor obamacare.

The majority don't favor "Obamacare" but when asked what they think about the "Affordable Care Act" they like it just fine.

It hasn't affected me personally, but has been a godsend to the patient population with whom I work.

NightNurseRN13 · Apr 23, 2014

I asked my son (11 years old) if he would give his xbox (one he worked very hard to get) away if it meant saving another child's life. Without hesitation he said yes, of course.

I know it's not the same, but do you know how much of your taxes go towards these programs like welfare and food stamps? If you are so concerned with that "loss" of money then I'm concerned with how much you make.

as far as the insurance debate goes, I just don't understand the "hold the poor accountable" vs. "we shouldn't force people to get insurance" ....pick one.

No one should go bankrupt paying for medical treatment. I think the real monsters here are the greedy insurance companies who got us here in the first place.

klone, MSN, RN · Apr 23, 2014

To be blunt, I'm not saying that. I am, however, saying don't tax me so they may live.

And that, my friend, is why we will NEVER see eye to eye. That sentence you wrote turned my stomach. It's hard for me to believe that there are people who have that opinion, but there it is in stark black and white.

toomuchbaloney · Apr 23, 2014

And that, my friend, is why we will NEVER see eye to eye. That sentence you wrote turned my stomach. It's hard for me to believe that there are people who have that opinion, but there it is in stark black and white.

That is a birdseye view of the value system of many Americans today.

Those remarks, honest remarks, reveal the Biblical story of the man laying in the street dying while people walked by, looked at him but ignored his need and crossed the street.

Funny how the Biblical parable is being played out in our modern world, isn't it? Funny how so many who claim a religious position (like the priest in the parable) want nothing to do with the man in the street, even if that meant that he died. That man (in the parable) was to be despised for his plight, after all, it was expected because of his station in life. Similarly, in our lives those sick and dying poor are referred to as lazy, takers, incompetent, unmotivated, whatever terms required to destroy compassion for the group.

Bitter walls separated the hearts of the Jews and the Samaritans. What sort of bitter walls are we building in the heart of this nation, and why?

OCNRN63, RN · Apr 23, 2014

And that, my friend, is why we will NEVER see eye to eye. That sentence you wrote turned my stomach. It's hard for me to believe that there are people who have that opinion, but there it is in stark black and white.

Yep, it's the "I've got mine, nuts to you" mentality that is so prevalent. "Why should I have to help someone get treatment for a life-threatening illness?"

I can't wrap my mind around people who justify military involvement in another country to make life better for them, but refuse to help those in their own country. (Not saying this is the case here.)

toomuchbaloney · Apr 23, 2014

Imagine a group of children with little to do. They roam around the neighborhood entertaining themselves.

At one corner they are confronted with a choice. They can help a man who has stumbled to get up out of the street and see him safely through the traffic, tend to his injuries, and set him on a safe path. This will likely take the efforts of all of them and may take some time to see it to the end.

OR

They can help the rich guy wash his new fancy and beautiful car hoping that they might get a ride it in and dreaming (when he throws them a nickle for their trouble) that they might one day own one.

Who are these children? They are Murcans.

SycamoreGuy · Apr 23, 2014

They are Murcans.

And this derogatory phrase is why we will never see eye to eye.

toomuchbaloney · Apr 23, 2014

And this derogatory phrase is why we will never see eye to eye.

Just that, huh?

LOL

Maybe you could extrapolate further on why that term divides us more than the difference in our values as human as have been explored here?