Healthcare Reform Section 2
The 2010 Patient Protection and Affordable Care Act changed the face of healthcare for its consumers, providers, and insurers. The unique perspectives of different interest groups significantly influenced the final draft of this bill. These same groups continue to lobby their elected representatives to either remain committed to the Act or to fight for its removal. Your group's responsibility for this assignment is to select a side of the debate that your group believes accurately reflects the party you represent in this discussion. Each group should remain engaged in the debate during the entire unit and offer more than "I think..." statements. Facts and data are encouraged and expected. Let the debate begin.
For Reform
Side Score: 12
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Against Reform
Side Score: 13
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Our group think that healthcare workers (non-physician) would be for the healthcare reform law because of the following: 1. With the new healthcare reform, it puts more healthcare workers where they are needed. "Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over five years) for scholarships and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 9% of Virginia’s population who live in an underserved area." (healthreform.gov) 2. The new reform implementing more nurse practitioners as healthcare workers could be a great thing alone overtime. Why? Nurse practitioners can take some of the burden off of doctors and nurses and cut costs. From what I noticed at the OB clinic (during clinical) the nurse practitioners performed some of what the nurses do as well as doctors. www.healthreform.gov/newsroom/ 3. Because the ACA lays the groundwork for more integrated care, including the tying together of local safety nets, together with its focus on insuring many more Americans, emergency room staff should see an easement of the burden they have shouldered for too many years. http://laborcenter.berkeley.edu/ 4. From what I understand we should post a supportive statement for healthcare workers and back it up with a reference. With the new reform, there will be a greater need for more healthcare workers and possible opportunities for advancement With the new healthcare reform, healthcare workers will be working as a team. Hospitals will work with physicians, nurses, patient advocates, employers and the federal government to give the most effective care. Healthcare workers will need to be trained in a more generalized manner. The need for nursing assistants and physician’s associates will increase and the need for specialized fields will decrease. Due to the increase in healthcare insurance options, more people will take advantage of generalized care. Therefore the need for paramedics, techs, nurses and supportive hospital staff will increase. The opportunity for advancement will also increase; paramedics could advance to RNs, techs to paramedics. http://www.healthcare.gov/compare/ Side: For Reform
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Healthcare workers usually don't want to work in areas where money is scarce such as in southwest Virginia. By not having healthcare workers in certain areas, it causes people to travel long distances to receive the proper healthcare they need. People who are unable to travel long distances are not receiving proper healthcare, therefore they are more likely to have untreated illnesses possibly causing them to die at younger ages. The healthcare reform would put healthcare workers in areas where they are needed allowing all people to receive proper healthcare. Side: For Reform
The new health reform can help healthcare team members by allowing other job roles to take part in other job demands. This new way of handling healthcare can cut down on stress within one job title. For instance, doctors can share some of their workload with nurse practioners in small clinics and hospitals. Nurses can utilize nurse practioners as well. Most nurse practioners started out as nurses this can help them share the work of nurses also. Side: For Reform
I believe that physicians should be against the health care reform for the simple reason that it has put many citizens in the position of not being able to afford health care. Therefore, people are not able to get adequate treatment from physicians because they cannot afford it. Health care reform is in a way forcing physicians to lower their care that their patients receive because of the high cost of health care that patients cannot always pay. Whelan, P. (2011, May). Doctors debate universal health care: pros and cons from the experts. Retrieved from http://familydoctormag.com/ Side: Against Reform
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Small business owners Small businesses don't get the credit they deserve. They make up for at least 25% of business growth. Small businesses employ less staff yet incur higher costs due to administrative fees, marketing, and hikes in insurance. Higher taxes take money away for plans to expand or make other investments. Higher taxes also takes away the ability for employers to offer health insurance to their workers. This leaves small business owners having to lower wages of their employees which in turn causes highly skilled people to often seek employment elsewhere. Under reform exchanges in small business would allow employees to choose from multiple health plans with better coverage and lower costs. It would also give small business owners a tax credit in which they can offer health insurance to their employees and use the credit to pay the premium costs. Reform for small businesses would mean tax equality between group and individual plans. 2) Defined continued option in which employers can donate a dollar pretaxed for employees to purchase their own individual health insurance 3) small businesses would be able to combine with other businesses across state lines to find the best insurance at the best prices, 4) portability would allow workers to keep their current health insurance if they seek employment elsewhere, and 5) medical liability reform would mean a reduction in healthcare costs. When small business employers are able to provide good benefits for their employees (insurance and decent wages), turnover rate is decreased, people are willing to come to work and be more productive. Health care reform for small businesses would benefit them greatly. NFIB os small business owners http://www.nfib.com/press-media/ Side: For Reform
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I agree 100% in that small business's do not get the credit they deserve. Small business's are the under dog's that contribute a great ton to the work force, and receive the least amount of credit in return. I believe the reform changes would make a positive change for all the small business's also, and I believe it is a necessary change that needs to be done. Currently with the way it is set up now small business's are needing a break. With the reform the employee's of these small business will be able to receive better benefits thus increasing productivity and work environment. These small changes will make the world of difference in the small business industry. Side: For Reform
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On March 23rd, 2010, the Patient Protection and Affordable Care Act embarked the beginning of an opportunity to enhance America’s health care system and most importantly, promote assistance to the well-being of patients in the healthcare setting. Under the ACA, individuals are derailed on the idea of being forced to have some level of health insurance; however, the fact is that the ACA is only protecting individuals and ensuring a healthy future for each and every American. For example, the ACA states that individuals will no longer be denied coverage or refused claims based on pre-existing conditions. The ACA also endorses medical research to gain a better understanding of complex diseases, with the hope of finding cures and treatments for individuals. One may argue that the ACA is financially impossible for many individuals; however a system of federal subsidies will completely or partially pay for the health insurance that over 34 million Americans currently do not have. In the patient perspective, this is an outstanding opportunity. The ACA may cause longer wait times to see physicians and possibly overly crowded healthcare facilities, but in return many more Americans will be insured, many less insurance claims will be denied, and patients will be encouraged to take part in preventative care causing less overall illness. In order to pay for this expanded healthcare coverage, there will be an increase in taxes and some individual insurance premiums will be slightly increased, but many people will be eligible for subsidies that will essentially cause their premiums to in fact be decreased. Therefore, in the eyes of the patient the benefits of the healthcare reform far outweigh the risks. Side: For Reform
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Our References: Manchikanti, L., Caraway, D., Parr, A., Fellows, B., & Hirsch, J. (2011). Patient protection and affordable care act of 2010: Reforming the health care reform for the new decade. Pain Physician Journal, 14. Retrieved from http://www.painphysicianjournal. Pipes, S. (2012, September 28). The affordable care act and its impact on patients. Human Events. Retrieved from http://www.humanevents.com/2012/07/10/ Side: For Reform
When talking about how universal health care will allow more access to health care to more Americans, it seems that the focus is on the coverage and lower costs of health care related to patients. Focus should be on how long it takes to get care. In other countries with some form of Universal health care surgeries can take months before they are performed, in fact , there are “legions of stories reported by the newspapers of people who have died while waiting for surgery” (Thomas, 2012). If access to health care leads to longer waits times, then many illnesses will be prolonged and/or worsened before proper care is administered. Preventive health care is a great incentive, but what if the flu season is over before the shot can be administered? Thomas, C. (2012). Foxnews.com. Retrieved from Health Care: http://www.foxnews.com/opinion/2012/06/ Side: Against Reform
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Nancy Pelsoi (Speaker of the US House of Representatives) stated, "[H]ealth insurance reform legislation expands private health insurance in America, and is based on increasing choice and competition... among a variety of private insurance plans." This states that there will be more private health insurances offered to patients rather than the small quantity offered currently, which will increase the number of health care facilities a patient can receive care. Also, the American College of Physicians (ACP) stated, "The recently enacted PPACA (H.R. 3590) includes numerous policies to train more primary care physicians and increase the supply of primary care physicians. These policies include: mandatory and increased discretionary funding for the National Health Service Corp (NHSC), reauthorization of Section 747 of Title VII, Training in Family Medicine, General Internal Medicine, General Pediatrics, and Physician Assistantship; creation of a Primary Care Training Extension Program and increased faculty scholarship loans, redistribution of 65% of the current unused Graduate Medical Education slots to primary care and general surgery and allowing residents to count their time spent in ambulatory settings to count towards their residency requirements, such as physician offices and community health centers; and the establishment of Teaching Health Centers, creating primary care residency programs in non-hospital settings." This states that not only will there be more choices of health care facilities patients can be treated at but there will also be more policies carried out to have more primary care physicians offered to patients to carry out care than the current number of PCP’s. http://healthcarereform.procon.org/ Side: For Reform
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I do not see how you could say that the new 2014 mandate takes away the patient's right to choose healthcare. According to the 2014 mandate, "In 2014, the penalty will be $285 per family or 1% of income, whichever is greater. By 2016, it goes up to $2,085 per family or 2.5% of income." This gives individuals 2 years to secure healthcare or pay $285 or 1% of income and then another 2 years after that to secure insurance of pay the fine. The average cost of private insurance in America is $183. If by 2016 the individual does not have health insurance he/she can take a private plan for their family and pay just $100 more than they would by paying the fine. Its like with car insurance. If you do not have a liability policy then you must pay the DMV the "uninsured motorist fee". This sparks most people to pay a little more and obtain a liability policy. Your always going to have charity care in place at hospitals that will provide high quality care at little or no cost depending on financial situation. I don’t know all the minute details of the tax penalties the government will implement against those who do not have health insurance, but I do know one thing. The health insurance companies absolutely love this law. They just got a guaranteed customer base of at least 50 million. And guess what? Premiums will come down because of it. Under ObamaCare, your monthly health insurance premiums will now be affordable. I have no idea how people can claim that health insurers will suffer. http://www.cnn.com/2012/06/28/politics/ 1 day 9hrs ago Side: Against Reform
Although there are some great points here about the benefits to American individuals regarding their long-term health and eventual financial savings, it’s the immediate increase in cost to the taxpayers that is of concern. Blendon, et al (2006) state that surveys show there is an overall dissatisfaction with the American view of the health care system (p. 627). Americans are concerned with the payments they will be required to make due to health care reform. Payments for insurance premiums, co-pays, deductibles, and costs of services and products, are all of concern (p. 632). Americans blame insurance and drug companies for the rising costs of health care. These individuals do not see their own habits as the cause (p. 636). Studies show that the uninsured are generally dissatisfied with the health care they receive (p. 638). This may indicate that they are blaming the system, not their own habits. Many Americans feel that there are ways to reduce the cost of health care, such as tax deductibles and tax credits for businesses that provide insurance to their employees. Government programs for low-income services could be expanded. These ideas are preferred over a single government plan (p. 641). Americans do not want more out-of-pocket costs. The insured individuals are likely to take shortcuts to avoid co-pays. The uninsured are likely to opt out of insurance because the penalty tax may be less than the financial cost of insurance, or the requirement to clean up their health habits. Reference Blendon, R., Brodie, M., Benson, J., Altman, D., & Buhr, T. (December 1, 2006). American’s views of health care costs, access, and quality. Mllbank Quarterly. 84(4). 623-657. Side: Against Reform
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Most physicians think that the healthcare reform will increase the access to government insurance programs, and will raise healthcare costs. Long term impact of this would be longer wait times to see physicians, fewer uninsured, and a change in incentives to providers. Many physicians are pessimistic about the healthcare reform and some will start to look for other options. Physicians think that the reform will hurt their incomes. There will become an increased demand for physicians because more people will become insured. Expanded scope of practice for physicians will reduce the quality of care that their patients are receiving. They think that payment reforms such as bundling will increase their administrative payments and therefore lead to a decrease in salary (Keckley, p., coughlin, S., Gupa, S. 2011). I am against healthcare reform in the eyes of a physician. I think that it will negatively impact their careers and it will steer many upcoming physicians away. Keckley, p., coughlin, S., Gupa, S. (2011). Physicians perspective about health care reform and the future of the medical profession. Retrieved from http://www.deloitte.com/assets/ Side: Against Reform
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From the viewpoint of the physician I would be against the healthcare reform. Although the idea behind the reform is good, valuing quality over quantity, many private practitioners would be forced to change many aspects of their entire practice. Physicians will be required to “standardize” their care, which in my opinion leads to less individualized treatment. Along with this standardization many physicians will feel like they are being hurt financially by this reform because they will be paid a lump sum for a specific problem to be treated, rather than the pay-per-service that healthcare is currently utilizing now. The Washington Post Staff Landmark: The inside story of america\. (pp. 203-226). Thorndike Press Retrieved from http://blackboard.jchs.edu/bbcswebdav/ Side: Against Reform
Physicians should be against a universal health care plan. The government couldn’t handle Medicare and Medicaid on a smaller scale. Physicians have a difficult time receiving reimbursements from the government which has “forced many doctors to stop treating Medicare patients altogether” (Ipsum, 2009). A CER (Comparative Effectiveness Research) council is being created to analyze cost effectiveness of types of medical care, which will “influence doctor’s decisions” possibly resulting in non-reimbursement for care; giving doctor’s “little incentive to provide better quality of care” (Ipsum, 2009). Doctors will make less money for more work prompting President Obama to warn “physicians will have to tighten their belts” (Ipsum, 2009). With increased workload and reduced salary physicians should be against Universal Healthcare. Ipsum, C. (2009). Good Sense Politics. Retrieved from Why are so many doctors against Universal healthcare?: http://goodsensepolitics.blogspot.com/ Side: Against Reform
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I think that the healthcare reform will negatively impact physicians. The goal of the reform is to increase the access to healthcare for patient while controlling the cost of care (Burt and Sharamitaro, 2011). Physicians may experience limitation on their practice which could decrease the amount of physicians (Burt and Sharamitaro, 2011). The reform will increase the amount of patients with insurance and waiting to see the doctors. I think that physician will have to perform more standardized care instead of the individualized care that they have been giving their patient. Another issue that physician will face is the payment of their services. The reform will make it so that payments will be lump sums instead of the way they have been paid until now which is pay per service. Burt, J & Sharamitaro, A. (2011). Healthcare Reform: Impact on Physicians. Health Capitol Topics, 4(2). Retrieved from http://www.healthcapital.com/hcc/ The Washington Post Staff Landmark: The Inside Story of America. pp 203-226. Thorndike Press. Retrieved from http://blackboard.jchs.edu/bbswebdav/ Side: Against Reform
The focus of physicians will shift to more generalized care and allow them to work more with wellness care for their patients. The number of medical students that focus on primary care will increase and the support staff will also increase. According to the Association of American Medical Colleges, our “nation would have a shortage of approximately 21,000 primary care physicians in 2015”. The primary care field has declined due to the aging population and medical students choosing specialty fields over primary care. The healthcare reform focuses on primary and preventive care and the Affordable Care Act is investing in the next generation of primary caregivers through training, incentives for physicians that provide primary care and support for medical students who choose these areas of care. The Act estimates 16,000 new primary care providers will be placed over the next five years. Preventive care structured properly will prevent disease and allow condition management before they become serious, therefore requiring less of a need for specialized care. http://www.healthreform.gov/newsroom/ Side: For Reform
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Having more healthcare workers such as nurse practitioners and physician assistants will make the work day of physicians less stressful. Their work day would not be as overloaded with patient visits. Physicians having less patients would allow them to focus more on the patients they do see instead of rushing through the visits to move on to the next patients, therefore giving their patients better treatment. Side: For Reform
I agree with that, because more times than not, the doctor seems rushed and you, as a patient, don't feel like you're being heard or listened to. Having more hc workers such as PAs and NPs to take the pressure off could give physicians more time to spend with their patients and minimize the risks of missing something important. Side: For Reform
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Taxpayer As taxpayers, we are very concerned with the proposals put forth concerning healthcare reform. We already sacrifice too much of our income to the state and federal governments in the form of taxes. How can the government think they can provide affordable health insurance to all American citizens without assessing taxes to those who can “afford” to pay them? And why should we allow government to control our choices regarding healthcare? The state of Massachusetts imposed a requirement for all residents of that state to carry health insurance, beginning in April, 2006. According to Steinbrook (2008), subsidies are available for those qualifying for a financial hardship, determined by tax returns. Those without health insurance must pay a penalty tax. In 2008, this amount was $912 per individual, annually. Approximately 10% of the state’s residents do not file tax returns. Therefore, they are not contributing to the funding of this type of universal healthcare. More importantly, they are not partaking in the plan’s ultimate goal to improve overall health and preventative medicine (Steinbrook, 2008). Tanner (2009) explains that residents in Massachusetts are required to purchase health insurance on their own, if it is not provided by their employer. He states that this system has failed. Healthcare costs are still rising and not everyone is insured. This plan has exceeded its projected budget and will likely continue to do so. No doubt this financial burden will be passed on to the taxpayers. There have been proposals for additional tax hikes for individuals, as well as taxes being assessed to businesses that do not provide insurance for their employees (Tanner, 2009). The idea of government regulating choices of this type has been unpopular historically. This is especially true when a tax increase is part of the plan. Mongan & Lee (2005) state that attempts to create a healthcare reform have been made repeatedly since 1974 when President Nixon proposed a plan. President Carter in 1979, and President Clinton in 1994 also made efforts to create a type of healthcare reform. Their attempts never got far. The plans were said to be too complex. In all three cases, a high concern was that taxes would have to be raised to support the financial burden of the plan (Mongan & Lee, 2005). Gapenski & Pink (2010) offer a chronological breakdown of the current proposal for healthcare reform. Some tax provisions will become effective as of January 1, 2014, as follows: 1. Tax credits will be offered to small businesses that have fewer than 25 employees and provide healthcare benefits for them 2. A $2000 per employee tax penalty will be imposed on employers with more than 50 employees that do not offer health insurance to their full-time workers. 3. An annual penalty of $95, or up to 1% of income, whichever is greater, will be imposed on individuals who do not secure insurance; this penalty will increase to $695, or 2.5% of income, by 2016. This limit will be the individual limit; families will have a limit of $2085. Exemptions to the penalty in cases of financial hardship or religious beliefs will be permitted. (Gapenski & Pink, 2010). For the average taxpayer, the idea of yet another tax to pay is not a desirable one. There is also the issue of employers being assessed fees if they do not provide health insurance to their employees. A likely argument would be that this cost would have to be extended to the customers of that business. The article, Tax Penalty to Hit 6-Million, suggests that some individuals believe by staying uninsured and paying the penalty, they may actually be saving money and coming out ahead of the game (Tax Penalty to Hit 6-Million, n.d.). Clearly, healthcare reform is not working in Massachusetts and, even more unlikely, is the idea that the plan can work nationally without a major increase in the amount of taxes American citizens are required to pay. We believe we have the right to make our own decisions regarding our health and the healthcare we may or may not seek. There is no room for government mandates that will in-turn punish the individuals and businesses of this country by assessing taxes to carry the financial burden. References Gapenski, L., Pink, G. (2011). Understanding healthcare financial management. (6th ed.). Healthcare Reform Update. Health Administration Press. Retrieved from http://acheweb.ache.org/pubs/ Mongan, J., Lee, T. (March 24, 2005). Do we really want broad access to health care? The New England Journal of Medicine. 352(12). 1260-1263. Steinbrook, R. (June 26, 2008). Health care reform in Massachusetts: Expanding coverage, escalating costs. The New England Journal of Medicine. 358. 2757-2760. Retrieved from http://www.nejm.org/doi/full/10.1056/ Tanner, M. (June 9, 2009). Massachusetts miracle or Massachusetts miserable: What the failure of the "massachusetts model" tells us about health care reform. CATO Institute Briefing Papers. 112. Tax penalty to hit 6-million who don’t buy health insurance by 2016. Retrieved from http://www.insurancejournal.com/news/ Side: Against Reform
The Congressional Budget Office concluded that repealing the ACA would increase the federal deficit by $109 billion over the 2013-2022 period. http://www.cbo.gov/sites/default/files/ Side: For Reform
There are various validating reasons why tax payers are against the universal health care plan. Tax payers are already disgruntled after having to pay state and federal taxes each year, so when it comes to health care taxes a great deal of people quite simply do not have sufficient income to pay health care taxes. The current health care system is full of taxes and tax increases that affect many individuals. Over the years the health care system has continued to grow in complexity and cost. This increase in cost has become a giant burden on tax payers. According to research done by ProCon, “46.3 million people in the US were uninsured in 2008 according to the US Census Bureau.” This is directly related to the fact that insurance costs and healthcare taxes have increased in the past years and are continuing in that pattern. According to Healthcare Payer News, “Employers can expect to see an 8.5 percent increase in healthcare taxes in 2012, a slight increase from the 8 percent increase expected this year …” This trend means that healthcare cost will continue to grow more rapidly than individual wages. This will greatly affect those tax payers in middle and lower class. Statistics have reported that “starting in 2014, virtually every legal resident of the U.S. will be required to carry health insurance or face a tax penalty.” (Alonso, 2012) It is obvious to see that the health care system is not benefiting tax paying citizens. Alonso, R. (2012). Health care tax penalty to hit nearly 6 million uninsured people. Huff post business, Retrieved from http://www.huffingtonpost. DeNavas-Walt, C, Proctor, B, & Smith, J. (2009, September). Income, poverty, and health insurance coverage in the united states: 2008. Retrieved from http://healthcare.procon. Pizzi, R. (2011, May 18). Pwc forecasts 8.5 percent increase in healthcare costs for employers in 2012. Retrieved from http://www.healthcarepayernews.com/ Side: Against Reform
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The taxpayers should definitely be against healthcare reform. It has been stated that this reform will cost trillions of dollars. Where do you think a big chunk of that money is coming from? Yes, there are many other ways that the government plans on forming the money for this healthcare reform, but there is no doubt that there will be a significant rise in taxes. The highest income tax rate which is currently at 35%, is estimated to rise to 43.4%. There is no way that the ACA could work without getting a significant amount of the finances from income taxes. Why does the government get to decide to take taxpayer money for our health insurance? Shouldn't we be able to decide if we want health insurance for ourselves? Why should hard working tax payers be forced to give an even larger amount of their income to the government to pay for the health insurance of the uninsured? I believe tax payers have every reason to be against healthcare reform. Side: Against Reform
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Insurance executives are against healthcare reform due to the potential effects it will have on overall operating costs and profits of the companies. "Fearing that a new public program could outcompete private insurance on price and quality, insurers launched a campaign against it, arguing that a government-run plan, with its favorable tax and regulatory treatment, would undermine the private insurance industry"(Quadagno, p. 450).Healthcare reform makes it hard for insurance companies to function as profitable entities and increases the pay-out cost. This will ultimately lead to job loss and the inability for insurance companies to compete for consumers. References Quadagno, Jill. (June, 2011). Interst-Group Influence On the Patient Protection and Affordability Act of 2010: Winners and Losers in the Health Care Reform Debate. Journal of Health Politics, 36, 449-453. doi: 10.1215/03616878-1271081 Side: Against Reform
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