how will health care reform impact the nursing job market?

Personally, I would like to see the insurance companies get a big slap down, because they are the ones screwing both the patient and the reimbursement the providers (nurses) get.

Now, this is interesting to me when people say this. I work for a major health insurance company (has a primary color 2x in the name ) full-time while taking my pre-nursing courses. I've worked there about 5 years, enough time to see how the beast works from the inside. Making health insurance companies "pony up" is not going to work -- the cost is just passed on to the folks that hold private and group insurance policies with them.

Let's take for instance, Medicaid. I work on the provider reimbursement side of the aforementioned company. I've worked many of these claims before, as the company administers some of these Medicaid plans in other states (when I say "administer", the state or federal gov't tells the insurance company how much to pay for each service, it is NOT up to the company). A doctor's visit typically pays about $7-$11 a visit under a Medicaid type plan (A normal "PPO" or something paying at the usual and customary rate would reimburse roughly $80-$100). Under Medicaid, labs are done for pennies. Pennies! I mean seriously, I don't know why any physicians would want to accept these patients - they ARE practically doing it for free! Now, what if we give millions more people in the country policies that reimburse this god awful amount, how are the physicians and all medical personel going to be reimbursed for their time appropriately? Thats right, they will need to turn to the private sector and demand higher reimbursements. This, plus forcing the insurance companies to never deny anyone for pre-ex, put a cap on out of pocket spending, forbid them to raise premiums of the sick -- what happens then? Private insurance becomes virtually unaffordable.

The heath care reform stages have just started, and already (as a ******* employee THERE!) my deductible went from $500 to $2000, my copays increased, my premiums increased. This is ONLY the beginning. Now, everything I said before is just my humble opinion - and like others have said, we just have to wait and see.

So, this all being said, I do expect the need for healthcare workers to increase, but I'm not sure how the bill is going to get paid

oops! sorry for the double post. Dern computer.

Healthcare is broken; but what was passed is not a fix nor is it a band-aid, it is just BS regulation meant to appease some powerful groups.

I hope for our sake, as bedside RNs, that the bill gets stopped

[linearthinker, DNP, RN]

It can't be stopped unless new legislation is passed. There isn't the support necessary for that, and it would be vetoed anyway. Repealing HC reform was just an empty talking point for the midterm election. We should have all insisted it be done right the first time.

I like to see someone start going after the CEO's and Nursing Exects of these healthcare systems who have not cut any of their over inflated salaries but put nurses out of work in the first place. The CEO's are making millions plus their health insurance, plus health insurance for their families, plus bonuses. The federal government needs to step in here- yes, it should be socialized medicine. Stop the commercializion of health care, stop the corporate healthcare. That's the only model of healthcare that is going on in this country. There is no such thing as"transional care at the bedside" or any other BS crap model. It's fed to us like candy- from someone's demented mind that has nothing to do all day but sit in an office and pick their seat all day, when they should be putting a pair of scrubs on and getting their lazy behind out on these units to see and EXPERIENCE first hand what is really going on. Give them a patient assignment to be responsible for - for 2-4 weeks. These people make sooo much money and are so faaar removed from the reality of all this. Then there are the MBA's who mind was only taught the fluff courses of sales pitches and profit making- what do they know about HEALTH CARE- Chronic disease- diabetes, renal failure, CHF,- NOTHING. So what do they care. Those conditions are only words and letters to them, meaningless words and letters that they nothing about and don't care to know. These exect. are so devoid of ethics and conscious that if someone or alot of someones die- they could care less 1. just as long as it's not them, and 2. just as long as they don't get sued. Nursing and Medical licenses- are something else that's not their problem- It's only the problem of those that hold them. Human life is a commodity- The nursing executives/management have long left their nursing ethics and traded them in for profit. They shouldn't even be allowed to use the initals RN, they shouldn't even be allowed to keep, or renew their licenses.

With the health care reform there will be a major emphasis on primary care. More people will be going back to their primary care physicians. It's going to take alot of educating the american public. The hardes hablit to break will be the misuse of the ED. There is going to have to be and increase in clinic, office hours. People still have to work- so those hours are going to have to expand, not to mention the number of clinics . The President signed a bill last April giving community and public health $122 ?million - that is only a spit in the ocean to the demand when $59.2 million uninsured or underinsured people get access to insurance. Hospital inpatient settings are not going to see any benefit from any of this- it doesn't include them. The whole goal of this reform is to keep people out of the expensive hospitals. Hopefully with this reform, with poeple seeking primary care, it will start to reduce the acutity of the american public through health education and prevention. Surgeries are supposed to be more outpatient as opposed to inpatient. In these infant stages, it would behoe of the powers that be in nursing to make barriers to keep MBA's out so they don't turn this into the profit mongering they made hospitals. If little johnnie cant do cheistry, patho, pharm and medicine and nursing, he/she needs to go to macy's or walmart for a job and stay the heck out of healthcare- their only killing people.

I think some areas will increase. With the new rule regarding parity of mental health care more people will be able to receive mental health services. With the change regarding preventive care services carrying zero co-pay and zero co-insurance there will be greater redemption of those services. I heard today on the news that there is a renewed interest in Washington about reforming medical liability. That would be fantastic for health care if it went through.

I think some areas will increase. With the new rule regarding parity of mental health care more people will be able to receive mental health services. With the change regarding preventive care services carrying zero co-pay and zero co-insurance there will be greater redemption of those services. I heard today on the news that there is a renewed interest in Washington about reforming medical liability. That would be fantastic for health care if it went through.

Reforming medical liability....tell me more about this. I'm interested.

I heard today on the news that there is a renewed interest in Washington about reforming medical liability. That would be fantastic for health care if it went through.

"Fantastic" how? It wouldn't save much money -- the total cost of the entire liability system, court awards, malpractice premiums, legal fees, lost clinician time, cost of "defensive medicine" tests and procedures, the whole shebang, comes to less than 3% of the overall healthcare spending in the US each year, according to the Harvard School of Public Health. That means that, if we snapped our fingers and suddenly made it impossible for anyone to sue for anything (no matter how legitimate the case), no one had to buy malpractice, no one had to order extra tests to cover their butts, etc., etc., etc., the savings would be less than 3% of annual healthcare spending. And we all know that, even if some form of "reform" is passed, it will be a lot milder than that ...

"How much do medical liability costs--including the costs of malpractice insurance, claims and legal fees and doctors practicing "defensive medicine" to avoid being sued--add to overall medical costs? During the recent debates over federal health care reform, considerable attention focused on whether medical liability reform should be included in the package as a means of reducing costs. Proponents offered some very high estimates (as high as 10%) of how much the liability system contributed to health care costs, while opponents trivialized these expenses. In an effort to separate fact from fiction--and to provide the first academic study of medical liability system costs-- a comprehensive analysis from Harvard School of Public Health (HSPH) researchers found that medical liability costs totaled about 2.4% of annual health care spending in the United States ..."

Medical Liability Costs in U.S. Pegged at 2.4 Percent of Annual Health Care Spending - September 07, 2010 -2010 Releases - Press Releases - Harvard School of Public Health