So what's going to happen to health care now?

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So, for better or worse, we have a new President. What do you think will be the future of health care and the future of nursing as a profession? Will we be better off as nurses or worse? Will we be better off as patients or worse?

Not looking for a political argument....god knows we've had enough of those in the past few days. Emotions are running high and we all have opinions. I'm just curious as to what we can expect.

The coverage gap only happens in states that refused Medicaid expansion.

The point is that people are unable to access health care.

Also, even in states that have expanded Medicaid, it is not that easy to qualify for Medicaid even though one has a very low income if one has more assets than are permissible by Medicaid rules. I live in a state that expanded Medicaid, and there are significant restrictions on the types and amount of assets one may own. Yes, the purpose of Medicaid is to provide health care to poor people, so it is reasonable to impose a limit on the amount of assets one may have in order to be eligible for free health care, but between being in real poverty and making enough money to qualify for an ACA subsidy there are a number of people who are in the middle, not making enough money to receive a subsidy, but having too many assets to qualify for Medicaid (and having too many assets to qualify for Medicaid does not by any means necessarily mean that one is comfortably off), who are faced with paying the entire cost of health insurance themselves, going without health insurance and paying the penalty, or spending down whatever assets they have that are above the Medicaid threshold so they can qualify for Medicaid. Another point is that in some states Estate Recovery applies to health care received through Medicaid, so one's Estate and one's heirs are subject to these provisions after one's death.

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I am cautiously optimistic. If the ACA remains as it currently is, we have all heard the horror stories about how premiums are going way up in January. People will not be able to afford those, and would start dropping coverage. Of course, this will be a Catch-22, as they will be fined. Currently, several insurance providers are also getting out of this business, or not expanding coverage as previously planned. That does not bode well for "universal coverage". I also currently know several doctors who are either opting for early retirement, or are not taking Medicare patients. My own MIL, when she moved here to KY, had a terribly difficult time finding a PCP who would take her Medicare insurer. And then it was several months' wait for an initial appt when she did get one to agree to accept her as a patient.

Suffice it to say, I think there are some good things coming if we can get them through Congress. I for one feel that if we can get interstate competition among insurance companies where you can purchase a plan from any insurance company in the country, competition will drive the prices down and make insurance more affordable. I also would like to see the fine for lack of coverage dropped, because I know lots of young, healthy adults who would like to opt for "no insurance coverage" until they are older. Also, I think I would like to see other healthcare models put into place, like clinics managed with a "membership fee", where doctors or NPs offer potential patients an annual plan where they charge an annual fee (say, $1500), and then each visit is only $30 and covers all lab work, diagnostics, etc. In the long run, the doctor knows what his income will be, and people's medical expenses would be a lot more affordable. I am just throwing a random number out there. . . but, I do know that some of these clinics already exist in KY, and are run by Nurse Practitioners. In this regard, there would be more options for nurses to manage care for patients.

I also think this sort of model could be used for lower income people as well, with clinics run on a sliding scale based on income. I have seen this in the past as well. These types of clinics could also be managed by NPs.

I also think employers offering HSA's on a wider basis would be helpful as well.

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Obama and the left wing politicians have made a huge mess. What family can afford a $1400/month premium in this economy? My families insurance has gone up, way up, and the coverage is less. The ACA was hastily tossed together and rammed through Congress. Then to top it off, no one read it. "We have to pass it so we can see what's in it, away from the fog of controversy" Speaker Nancy Pelosi. This mess was created in a profoundly partisan way. Any bill that would affect so many should have been passed with full support of Congress, not just the Democrats. They are responsible for this mess and cannot deal with reality. The people have had it with these failed policies. Evidenced by Trump being elected to the White House. Now we will have to go through the cleaning up process. The redistribution of wealth plan has failed. I hope things get better for the people. Those on tight budgets need relief.

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Obama and the left wing politicians have made a huge mess. What family can afford a $1400/month premium in this economy? My families insurance has gone up, way up, and the coverage is less. The ACA was hastily tossed together and rammed through Congress. Then to top it off, no one read it. "We have to pass it so we can see what's in it, away from the fog of controversy" Speaker Nancy Pelosi. This mess was created in a profoundly partisan way. Any bill that would affect so many should have been passed with full support of Congress, not just the Democrats. They are responsible for this mess and cannot deal with reality. The people have had it with these failed policies. Evidenced by Trump being elected to the White House. Now we will have to go through the cleaning up process. The redistribution of wealth plan has failed. I hope things get better for the people. Those on tight budgets need relief.

The ACA was not "hastily tossed together and rammed through Congress." There was extended discussion and debate, many elements added and subtracted from the bill, and weeks of hearings held by the Senate Finance committee (I remember, I watched most of them) before it was brought to a vote. There was the same period of time between when the bill was finalized and the vote occurred that there is for every other bill, as prescribed by the rules of the Congress, and, regardless of Pelosi's unfortunate statement, anyone who didn't read the bill prior to voting on it has only her/himself to blame for that.

The final version of the ACA is a mess precisely because the Democrats took out many things that the Democrats wanted, and put in things that the Republicans wanted, in order to create a final bill that would be truly bipartisan and the Republicans would be able to support. The final bill is nothing like what Democrats would have written on their own. And, in the end, after including all kinds of things the Democrats didn't want and the Republicans insisted be included in the bill, the Republicans still wouldn't vote for it, mostly, I believe, so that they can complain about it to their constituents and be able to say that they didn't vote for it. The individual mandate, for instance, was originally a Republican proposal many years ago, and they had been advocating for it for years, right up until the Democrats included it in the healthcare reform bill because it was something they (thought they) knew the Republicans wanted -- and, then, as soon as the Democrats put it in the bill, suddenly the Republicans were opposed to the individual mandate, and they've been complaining loudly about it ever since.

The Republicans made sure that the bill would be a mess that wouldn't work, far different from what the Democrats originally wanted, then refused to vote for it, and now have spent all their time since then complaining that the bill is a mess that doesn't work, and blaming the Democrats for it being "partisan" and reminding everyone that none of them voted for it. The entire process was reminiscent of Lucy holding the football for Charlie Brown. They set up the Democrats; the well-meaning and sincere Democrats, trying to be bipartisan and "team players," made the mistake of trying to work with them, and they've been beating the Dems over the head with the law ever since.

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Where do any nurses have pensions these days? Do they have any openings for me?

The federal positions still have a pension as do most state jobs.

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The federal positions still have a pension as do most state jobs.

That depends on the state. My state eliminated defined benefit pensions for state employees years ago; there are still a few "old-timers" who are going to be getting a pension, but all new hires have been put into a defined contribution retirement savings (401k-type program) program for many years now. I believe that is true in plenty of other states, also.

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He is president-elect. He is officially president after the inauguration.

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Specializes in Medical-Surgical, Emergency.

My view on what will happen, he will open insurance companies to be sold across state-lines which will broaden the market, slash through geographic monopolies and allow the beauty of competition to flourish. This will drive companies to provide highly competitive rates to consumers. He is not going to touch pre-existing condition legislature, keeping kids until 26. It's going to have some tremendous effects in my opinion. I think we're going to see drops in premiums and deductables. Competition will allow the true supply/demand variables to drive market prices down. Companies will be forced to provide truly affordable/solid plans in order to compete and stay alive, because if Company A won't then Company B will and everyone will shop there. If you couldn't afford it before, you certainly still couldn't afford it after ACA, didn't solve anything. Not to mention states who didn't expand medicaid benefits. This will actually free-market dynamics to force insurance companies to provide reasonable, affordable, and good policies.

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Specializes in Hospice.

We've been listening to that "free market" schtick for almost 50 years, now. It hasn't worked yet.

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My view on what will happen, he will open insurance companies to be sold across state-lines which will broaden the market, slash through geographic monopolies and allow the beauty of competition to flourish. This will drive companies to provide highly competitive rates to consumers. He is not going to touch pre-existing condition legislature, keeping kids until 26. It's going to have some tremendous effects in my opinion. I think we're going to see drops in premiums and deductables. Competition will allow the true supply/demand variables to drive market prices down. Companies will be forced to provide truly affordable/solid plans in order to compete and stay alive, because if Company A won't then Company B will and everyone will shop there. If you couldn't afford it before, you certainly still couldn't afford it after ACA, didn't solve anything. Not to mention states who didn't expand medicaid benefits. This will actually free-market dynamics to force insurance companies to provide reasonable, affordable, and good policies.

Let's hope you're right. Many of us are in a limbo at the moment. I used to have excellent care through my old job, but lost it when i quit work for nursing school. Now I am paying almost double for far less benefits, and unsure if I can afford the premiums in a long run. It is frightening :(

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That's pathetic! Move to SC and live a comfortable life. Ours has gone up, but not that bad. It still sucks. I have been a nurse 26 years. I can remember a County job I had in the 90's my Insurance was free!

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That's pathetic! Move to SC and live a comfortable life. Ours has gone up, but not that bad. It still sucks. I have been a nurse 26 years. I can remember a County job I had in the 90's my Insurance was free!

Your insurance was never "free." The cost of the insurance, whether it's paid by you or by your employer, is the cost of the insurance, and you're paying for it either way. If the employer isn't charging you directly for the cost, it's still money that you've earned but never see, that's skimmed "off the top" of your paycheck and the employer claims the tax deduction.

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