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.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I would hope that the ACA would not be repealed entirely, but I feel like certain aspects were in trouble regardless of the election results (companies taking themselves out of the insurance exchanges, requiring insurance despite climbing premiums, not seeing the cost savings that was anticipated). I would anticipate thrse aspects to be gone without a replacement in this political climate.

Never mind that a lot of previously-insured people lost their insurance because of ACA (me included). Recently, a lot of people insured through the ACA have been sweating it because premiums have been skyrocketing.

The ACA never did address some of the root causes of health care expense (like tort reform) and is unsustainable in its present form. Impossible to predict what will happen next, but change certainly was inevitable. Election or no election.

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i used to work in the hospital, and the health insurance i had through the hospital was $250/month much more affordable than the what obamacare insurance companies offered through the marketplace.

i dont know whats going to happen to be honest. i wish we had England's NHS or Canada's national health insurance. why cant we have that here in the usa?

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Specializes in LTC Management, Community Nursing, HHC.
I hope we can get something more affordable. We kept BCBS we had prior to Obamacare and it is going up to $900 a month in Jan. Mine is $10k deductible and hubbys is 3.5 k

Checked into Obama care this yeat and mine alone was going to be 900. Not eligiblefor subsidy as our income is aprox 80k

We have the same problem. Our health insurance was about $200 a month prior to Obamacare, it went up to about $470/month, and now it's going to be about $800 a month on a much lower level (i.e. bronze) with a deductible of about $12,000. Pretty frustrating as all that is just for 2 adults.

At this point, I think anyone who can change things for the better, will be worth listening to, and working with. I'm certainly hopeful that something good may come out of all this. Executive orders just don't work in a democracy.

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i used to work in the hospital, and the health insurance i had through the hospital was $250/month much more affordable than the what obamacare insurance companies offered through the marketplace.

Please understand that the reason it is more affordable is because the hospital picks up a huge portion of the tab. I recently switched positions and had to utilize COBRA. When I worked for the hospital my share of the premiums was just under $300 for my family. With COBRA it is just under $2k.

I'm always amazed that some folks want to maintain the the disallowance of discrimination based on pre-existing conditions but are opposed to the mandates. What will people do? They will wait until they get sick and then purchase their insurance. That would be a mess. Twenty years ago there was an HMO in the NW that had to stop selling individual policies because people were routinely buying the policies just for maternity coverage. They would pay their fairly low premiums, get the great coverage and then drop as soon as they had their kid. It was unsustainable.

I truly wish insurance companies and employer based insurance would just go the heck away. I want to stop paying premiums to an insurance company. Let me keep that money, tax me an extra *whatever* and ensure that everyone has access to good care and put the insurance companies out of business! Sorry to those of you who work for insurance companies.

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i dont know whats going to happen to be honest. i wish we had England's NHS or Canada's national health insurance. why cant we have that here in the usa?

Because of the Republicans. Be sure to thank them.

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Specializes in Critical Care and ED.
I am conservative leaning, but after getting to research healthcare system around the world, I realized that systems like the NHS are really the way we need to go.

Also, maybe we'll get lucky and Press-Gainey will no longer decide reimbursement!

I'm originally from England and I worked in the NHS for 10 years before I came to America. While there are many good points about the NHS there are also many negatives. Going to an NHS style framework would mean much longer waits for patients...sometimes years for surgeries...much lower wages for nurses and literally zero choice for patients. Nurses wages in the UK are capped and formed into bands where you cannot earn beyond that unless you fulfill certain criteria. In England I earned 4 times less than I do here pound for dollar. There is much less ability to climb the professional ladder and less reward. There is so little money to go around that hospitals are old and groaning under the weight of patients. You cannot choose your doctor at all and you have to be referred to a specialist that takes months to get an appointment with. I am glad I don't work for the NHS anymore. However, the positives are that I never received a bill in my life for medical care there. My parents have medical care whenever they need it although they often have to wait a long time to get seen.

The perfect system would be a hybrid. Funding from multiple areas...taxation and private insurance. Those who can afford should have the ability to buy a better insurance while those who cannot should have at least the safety net of basic, decent care free of charge. America has made things way too complicated with the whole ICD 9/10 thing. There is so much red tape and so many bureaucrats that it's out of control. ACA was a start in the right direction but it's not sustainable in the current model. Having said this, repealing it will be a huge mistake because it will leave us back where we were but now everything is more expensive. It's not like prices are going to go down!

I too remember earning good money 10 years ago. Things weren't so tight and we could get travel reimbursement and bonuses and all that disappeared and the penny pinching started. For one side to gain the other side has to lose it seems. We need a system where everyone gains. I foresee caps on nurses wages if we're not careful. We cost too much money and they have to get that from somewhere. That's why I started accumulating degrees and certifications. Make yourself desirable.

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Question, what is the change in health care with legalizing marijuana? I do not smoke. I am curious on the prediction.

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Specializes in IMC, school nursing.

I read the whole ACA, it was set up to fail, thus ushering in the utopian federalized healthcare. Dr. Carson has been enlisted to help in this. The major ideal that must occur is the erasure of state lines. Despite what Bernie says, the free market has always driven prices down (don't believe me? Say Epi-pen). By mandating availability to all, the pre-existing argument is gone. Mandated enrolment will be repealed. I personally know of multiple people who didn't come to the ER until they were on death's door knowing they were breaking the law by not being insured, smh. Let's get rid of teaching kids social indoctrination and start giving them economics instead so they realize the number one reason for bankruptcy in this country is being uninsured medically, and maybe more young people will pay into the system.

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Specializes in GENERAL.
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.

Question#1:

The republican plan in a nutshell for healthcare insurance which is the cornerstone of all "health care" in the U.S. will be to dismantle "the affordable care act" and replace it with "the dopey act."

Their free market Adam Smith inspired plan is to let the 'free market' reign and allow the health insurance companies to compete across state lines to in effect bring down premium prices across the board.

Sounds like a good idea and in theory market competition does work on the local level for small business.

You don't like the price of peaches at Kroger, you go to Publix.

But the health care companies are not small business. Their prime directive, if you will, is to monopolize any industry that thay can. As Rockefeller said " you call it monopoly, I call it enterprize.

So at least initially interstate competition will lower prices of health insurance but not for long.

As the larger, better capitalized companies get a strangle hold on any particular region's market you will see prices go nuts. It will be even worse than before Obama Care. Than even Obama Care itself.

Look it comes down to whether you believe heath care is a right or a privledge.

Whether you believe preexising illnesses should be covered or there should be paultry lifetime hospital caps or Mary or Johnny should be insured on their parents plan till they're 26 because they can't find a job with insurance in a tepid economy.

For the providers and those forced by law to take care of folks gratis, the system will always support the out of sight out of mind approach to providing care to the broke. "As long as somebody else is paying for it it's fine with me." The problem is that 'sombody else' is all of us, the taxpayers and the patients who show up at death's door reqiuring the million doallar work-up that again we all pay for by cost shifting.

Question #2:

As far as the future of the nursing profession is concerned, most don't even know it's a "profession" until they get sick. Then you'll hear I had no idea you people did anything more than order out pizza. Thank you for saving my hisband's life."

So with the" Commander in Hair" newly elected, we are in trouble. The health of nursing is proportionately related to the health of nursing education.

With the legacy of sham schools like "Trump University" and most of the for-profit loan mills recruiting the desperate, impatient and ill-prepared, this absolute rapine on nursing education and nurses will not only continue but most likely be encouraged and continued by among others, the silent majority of nursing leaders and educators that either participate in the scam or hide under a rock.

And, of course, the Wall Street money lenders.

Hail to the Hair!!!

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Specializes in Critical Care and ED.

Don't forget that the reason the ACA was imperfect was because Obama was blocked at nearly every turn by the Republicans! If they had been able to implement it properly it would have been much more successful.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
i used to work in the hospital, and the health insurance i had through the hospital was $250/month much more affordable than the what obamacare insurance companies offered through the marketplace.

i dont know whats going to happen to be honest. i wish we had England's NHS or Canada's national health insurance. why cant we have that here in the usa?

Canada does NOT have national health insurance. That is a common American misconception. Healthcare in Canada is administered provincially.

That was likely one of the main flaws with Obamacare: being administered federally. Generally speaking, the bigger the administrative entity, the more opportunity there is for waste, fraud and inefficiencies. Think Medicare.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Found at Crains Business newsletter

From Philadelphia Inquirer

by Harold Brubaker

Nov. 8, 2016

Analysis: Trump presidency could impact Philly hospitals

Philadelphia's modern economy is built on the back of the region's meds-and-eds – its health systems and universities. But with the election of Donald Trump as the nation's next president, some say hospitals could face major financial challenges

.... On the trade front, life could get harder for Philadelphia firms that manufacture products abroad for U.S. consumption. Trump has said he would rip up international trade deals, such as the North American Free Trade Agreement.

Trump cannot do that without Congress, but if he got his way, that could unleash a trade war, plunge the U.S. economy into recession, and cost more than four million private-sector jobs, a September report by the Peterson Institute for International Economics said

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For profit hospital corporations stock took nose dive: HCA, Universal Health Services Inc, Tenet, Community Health Systems while drug manufactures stock rose due to potential reversal of ACA cost controls.

Only 1 company Independence Blue Cross has plans in Philly areas healthcare exchange with rates increased 26%. IBC affects lives of 10million persons, 2.5 million just in my 5 county Philadelphia area.

IBC 2015 report: How your premium dollar is spent

We spent 83.3 cents of each premium dollar to pay for our customers' health care in 2015. We used 12.1 cents to run our business and invest for the future. We used 5 cents to pay taxes — a total of $695 million in federal, state, and local nonpayroll taxes. For taxes and fees related to the ACA alone, we paid $263 million — nearly 30 percent above what we paid last year. We made no profit in 2015. The medical services used by individual members increased significantly, as did the amount we spent on specialty and high-cost, brand name prescription drugs, resulting in a -0.4 margin.

My spouse has been high utilizer of healthcare with IBC paying bills. Thankfully, my health system buying power has no increase in premiums for 2017. Expect TRUMP changes to hit in 2018. Very worried what helathcare will look like in 2022 when I retire.

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