wirehead

No doubt the ACA has raised premiums, I can give you an actual example affecting my family. Prior to the passing of the ACA, my sister had a BC/BS EPO plan that fit her needs and cost $198 per month, no in-network deductibles, and $20 co-pays. Since the ACA, that plan has steadily risen and benefits have decreased significantly, the same plan now costs her $466 monthly with a $2,500 in-network deductible, and $40 co-pays. Needless to say, she's dropped her insurance, and will deal with the cruel penalty because it she simply can't afford it as a single mother. My other sister faced a similar scenario, she and her spouse had another BC/BC product that was in the $400 per month range, their monthly premium jumped to over $1,000 per month with in-network deductibles, they too are now uninsured. I'm sure this is a common theme among many of our friends and family. I'd like to see the ACA reformed, it's too late for repeal, keep the good parts, lose the bad, open up the playing field to allow out of state companies to compete, and target Medicare/Medicaid fraud, and tort reform.

Hi SmithRN, Great post. I too work in home care, and what KILLS me is how a patient on Medicaid can get unlimited amounts of wound care supplies/dressings while Medicare patients, many who are war veterans, cannot!!! They've paid into the system, worked most of their lives and they get the shaft! Insane stuff!!

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/

MunoRN $81/month average premium, I'd love to see a reliable source for that #. The ACA expanded Medicaid, that's why there are less people uninsured, ever see a Medicaid patient get an appointment with a decent doctor in a timely manner??? Medicaid reimbursement doesn't cover the cost of the toilet paper rolls in the hospital bathroom. Hospitals are not better off!! As for those who have purchased plans through the exchange, what good is coverage with insane premiums, deductibles, and copays?? I remember Obama during his debate with Romney state that while he is POTUS the sequester will not happen!! Didn't see him work very hard to prevent that. Not only is Medicare reimbursement going down, but remember when its budget was cut to pass the ACA? Sure value based care should be rewarded, but the system is not able to handle all the newly insured so more volume and less healthcare workers equals disaster. While adequate CNA staffing is important, they do not provide skilled care, adequate nurse/patient ratio's are way more important. I guess the American public agrees that the ACA isn't working considering the election results. At the end of the day, working together will get things done, this country has been so divided the past 6 years. I know all of us on this board want to advance our profession and focus on priority one, the best possible patient outcomes.

You mean all those republicans that just won back the senate??? The people have spoken!! I'm sure all those affordable ACA premiums and its positive effect on healthcare had nothing to do with the huge loss of the democratic party today, NOT!

Great read. Impact of the Affordable Care Act on the Health Care Workforce

Capitalism is what makes potential in the US amazing! I may hate some of the ways our country is run, but I love it 100%!

Good point elkpark, I see a lot of people including myself getting slammed for a difference of opinion. It is paramount that we remember that healthy debate is good, and can get great things accomplished. One thing I will say about those completely relying on science and evidenced based practice, keep in mind science evolves as does ebp.

Hi blondy, This is known as manipulation under anesthesia (MUA), it's very helpful for contractures, or for things such as frozen shoulder or muscles that are in major spasm. Here in NJ, the sedation is NOT done by the Chiropractor, they do this at an outpatient surgical center and there is an anesthesiologist who performs the sedation and monitors the patient. Typically the use versed or propofol, and the patient is out for a very short period of time. I don't know if other states allow Chiropractors to administer sedation, but I highly doubt it unless they have extensive training to do so.

Good question, if it's for migraines, I'd say find an alternative, if it's for cancer, HIV or severe chronic pain, then as Sun0408 has mentioned, you have to consider if you're ill enough that maybe you shouldn't be practicing until you get a handle on your illness.

I've had my share of crappy instructors, some with great credentials who just weren't engaging, or just possibly burnt out! At the end of the day, nursing school is very demanding and you have to be up to the task regardless of the workload. You really have to suck it up and give it your best. Some instructors do not give a crap if you pass or fail, but most do! It's really up to you to pay attention in class, study, ask questions, engage your instructor regardless of your perceived notion that they have it in for you, and use your classmates to help you grasp a particular topic. There were classes I felt that I was completely on my own, but you are provided all the materials you need to pass your exams. Stay positive, stay focused, and create a time management plan that allows you enough time to study, go to clinical, and complete your assignments. This may mean no social life for awhile, but remember it's all about delayed gratification: suffer now, prosper later! Good luck

"PEDSRN" I think you make a good point, but our nursing curriculum prepares us very well how to protect ourselves from those conditions you have mentioned. How much have we learned in US schools about Ebola?? I can't even recall it being mentioned in detail if at all during school. Even the CDC isn't well versed on the topic, remember green lighting the potentially infected nurse to board an airplane who was in fact infected!! Look at HIV in the beginning, it was thought to be primarily transmitted by homosexuals, now we know so much more about it, and how it's spread. I say until we gain a better understanding of this disease, Kaci should've quarantined herself for the 21 days period and erred on the side of caution. To those of you making this a politically correct issue, you need to get some thicker skin.

For a family of 3 based on our specific details, in our county for a platinum plan it would cost us $1,449 per month to come close to our current coverage, this one doesn't have an in network deductible, for $1,229 per month we would have a $1,500 in network deductible. $5,500 yearly is either an individual plan, or a catastrophic plan.

The ACA has thus far been a disaster. It was rammed through in the wee hours of the morning without 1 Republican vote. We were promised the most transparent government in history under President Obama, health care reform would be televised on CNN, be a bi-partisan crafted bill, and most of all, "you can keep you health plan period, you can keep your doctor period." NOT!! I agree with lifting the pre-existing condition rule and lifetime limits, kids are not kids at 26, and if you have a young adult who is disabled we have disability/Medicare/Medicaid for that. These issues could've been addressed through legislation, not major overhaul. If you do the math according to the CBO, the amount of money spent on the ACA website, plus advertising, could have covered every uninsured American for 20+ years. Amazing!! All those tax dollars for an unsecure website and moronic commercials trying to drum up support wasted. No doubt the system wasn't perfect, but to ram through irresponsible legislation that's somewhere around 2,700 pages, that nobody read, riddled with penalties, then you're simply acting out of emotion, not common sense. On top of all that, keep in mind, more people have lost insurance than have gained insurance under the ACA, and most of those who became eligible were put into the current Medicaid system. For the heck of it, I checked out what a plan would cost me in NJ compared to my current awesome plan who's premium has doubled since this legislation took place. The basic plan is not even worth mentioning, I went straight to the Platinum plan, for my family it had an in-network deductible of $7,500, and costs 3x's more than I pay now, with less overall coverage. In fact, in my county, there is 1 hospital that participates with ACA insurance plans, and it's not that close! Every doctor I talk to is spending thousands to become compliant with the ACA, and others are just retiring. It's not just doctors, it's hospitals, nursing homes, and urgent care clinics all being affected, rising costs, less reimbursement equals laying off workers, and reducing hours. You can't make the cost of doing business increase and expect employers not to find loopholes to stay afloat. I don't know many places in business to lose money!