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1 point

Actually, healthcare reform would aid small business by reducing the costs of obtaining healthcare insurance for their employees. This would take place through an “insurance exchange” that would let small businesses choose from a large number of insurance plans that provide better coverage at lower costs. For small businesses that are unable to provide health insurance coverage, this exchange would allow for workers to obtain better and lower-cost options for health care coverage. Low income families would be placed on a sliding scale coverage plan to help them obtain insurance.

According to the Executive Summary, The Economic Effects of Health Care Reformation on Small Businesses and Their Employees (2009), the current health care system “…imposes a heavy “tax” on small businesses and their employees. Due to high broker fees, fixed administrative costs, and adverse selection, small businesses pay up to 18 percent more per worker than large firms for the same health insurance policy” (p. 2). These higher costs prevent many small businesses from supplying employees with health insurance coverage.

Under the health care reform, incentives for medium and large firms to offer health care coverage would be provided through a “pay-or-play” program. Small businesses would be exempt from this program. The reform would also encourage entrepreneurs to launch their own businesses thus increasing jobs that would be available, helping to alleviate unemployment.

By providing health care coverage options to small businesses, employers would see a reduction in call-ins from illnesses. Employees would be able to seek medical care and maintain better health outcomes due to the availability of insurance coverage. Health insurance coverage allows for prevention as well as providing coverage for illness.

According to the Executive Summary (2009),

Successful health care reform that genuinely slows the growth rate of costs will greatly aid the overall economy in general and small businesses in particular. Controlling costs will cause living standards and take-home wages to rise more quickly for American workers. Reform will lead to increases in entrepreneurial activity and to a more efficient allocation of workers throughout the economy. And by reducing future federal budget deficits relative to what they otherwise would have been, health care reform will serve to lower the cost of capital and reduce future tax increases for small businesses, which will lead to more investment and job creation in this key component of the economy (p. 14).

Due to these facts, many small businesses are embracing health care reform.

Reference: www.whitehouse.gov/.../Health-Care-Reform...Small-Business.

1 point

It is true that no one can dispute healthcare is in trouble. We all know it but no one wants to think they will shoulder the costs. In reality, as our healthcare system stands today, we are all shouldering the burden.

According the AHRQ web site, 70% of US healthcare dollars are spent on chronic disease care. For those Americans little or no insurance coverage, they must either put off getting help or use the emergency room. Either route means a big bill for something that could have been prevented.

The benefits are two-fold. The bill will provide affordable coverage to all Americans. Those who are delaying care or using the ER’s would be able to establish with a care provider for monitoring of conditions and stopping problems before they become costly.

The bill also increases the payment to non-physician providers. This has several benefits. The increased payment is a financial incentive to become a non-physician provider. More providers means better access to care. The non-physician providers are trained to focus on teaching self-management skills and in chronic disease management.

It is true that the bill will have an impact on some Americans tax bills. Again, as the healthcare system exists today, everyone is paying the bill by increased insurance premiums, increased co-pay and co-insurance, and increased cost of services. It stands to reason that if a small tax increase is swallowed now, then we can prevent being choked by skyrocketing healthcare costs in the future.

1 point

As a health care provider, I believe everyone deserves quality health care. There should be health care available for all medical conditions including pre-existing conditions. Statistics indicate employer based health insurance as well as other types of health insurance continues to decline. (Gallup.com/poll/148079/employer-based-health-insurance-declines-further.aspx) As health insurance declines so does the health treatment of citizens. In many instances, profit is considered over treatment of patients (http://www.pbs.org/wgbh/pages/frontline/shows/hmo/procon/patients.html). While health insurance is a major contributor to poor health care there are also other factors. When people do not have health care insurance they neglect to seek medical attention as “well” patients. Instead, they wait until there is an absolute need and by that time the treatment may be more expensive than if the symptoms had been treated before the medical need escalated. Many people needing medical assistance do not get it due to the fact they are unable to pay for it and fear financial ruin in the event the treatment costs are extravagant. While there are programs to assist in payments, many patients are unaware of the programs or make too much money to qualify for them. Often when patients do qualify for the benefits, their paper work is lost in the process and the stress involved in convincing the hospital administration they completed the paper work does not help their medical condition.

Over a period of time, the insurance companies have priced the average American out of health care benefits. The insurance companies are more concerned with profit than meeting the needs of the citizens. Competition within the health care insurance companies has allowed the rates of health care insurance to soar. What was once a household benefit has now been limited to those who have money.

Health Care reform is needed to insure all citizens have the available funds to pay for needed care without the hassle of stacks of paperwork to show eligibility. Whether the insurance company is paid by private insurers or by government funding, insurance companies need to be held accountable for the monies the policy holders pay. To offer affordable care, there must be controls in place to monitor each dollar the policy holder pays. The policy holders are paying for a service so the money paid to the insurance companies should be spent on the insured. Six figure salaries and benefits to the insurance executives need to be capped. Reserve amounts to pay future claims are calculated into the premium payments. With proper management from the insurance administration, it should not be necessary to increase these amounts. Health care reform will not affect the insurance companies if intelligent changes are made governing the parameters of claims processing. Changes in stream-lining operations to eliminate excess hiring, accountability in spending at the executive levels, salary reviews and adjustments, and auditing of general, everyday spending are some ways to curb spending.

Drugs should be monitored more closely to determine if patients really need so many. There are some restrictions and information sharing of the drugs patients are prescribed but more should be done to protect the patient and the payments involved. The money saved in these simple changes would off-set any additional spending necessary for offering health care to non-insured citizens.

Government requirement of health insurance would be a positive health care reform to insure all citizens have coverage for health care. The profit margin to insurance companies would not decrease; it would increase. Do the math, an increase in policy holders means an increase in funds. Yes, the claims payments would increase but the percentage allowed per insured for administrative costs would also increase as this amount is automatically calculated in the insured’s premium.

1 point

Dispute Physician Argument

There is a legitimate concern about the ability of current primary care providers to be able to handle the influx of patients that is predicted due to the healthcare reform bill. The bill has provisions to address this concern.

According to the US Department of Health and Human Services the provisions of the Affordable Care Act supports training, development, and placement of new primary care providers. The act also gives money to states to develop unique strategies to expand the primary care workforce.

The bill also increases payment to non-physician providers. Non-physician providers focus on chronic disease and self-management of disease. By taking this burden from primary care physicians, they can focus on the more acute cases.

The bill also increases payment to primary care providers. This financial incentive will hopefully keep primary care physicians working in primary care and entice medical students to choose primary care as a specialty.

The Affordable Care Act isn’t perfect. The plan is complex and extensive. Most of us must rely on others to read and interpret the plan. It appears that the authors of the bill anticipated the negative effects of the bill and made provisions to offset the negatives.

ProCon website : www.procon.org Aug. 23, 2010

US Department of Health and Human Services – www.dhhs.gov

1 point

While it is said that this act will ensure that everyone will have health insurance, this is not true. Many people will loose their current healthcare coverage. One of the main groups effected by this would be small business owners. They will have to pay higher taxes and this could result in all kinds of problems for them. With requiring that everyone has healthcare many feel like this is unconstitutional. Telling people what they have to do when they are given certain rights as a citizen of the United States under the Constitution doesn't go over well. It is said that this bill will lower healthcare premiums and cost, but it will actually raise them. They will be raised because the cost that prescription manufactures will pay will go up. There will be new taxes on medical devices and both of these things being raised will cause the patient to pay more for their prescriptions and will cause overall higher insurance premiums. This bill is said to solve the problem of medical bankruptcies, but it will actually cause them. The Patient Protection and Affordable Care Act is an overall bad thing for the patients.

Reference:

Health Care Laws/Obamacare. Retrieved from http://healthcarereform.procon.org/view.resource.php?resourceID=003725. Retrieved September 28, 2012.

1 point

For Healthcare Workers (Non-Physician):

The Patient Protection and Affordable Care act includes many provisions that will positively affect health care workers with grants and initiatives for recruitment, retention, and education. It will also include initiatives for new models of care, and expand healthcare coverage to millions of Americans.

Provisions in the act are designed to increase the recruitment and training of many health care professionals, including primary care, public health, and nursing, and increase the diversity and cultural competence of the healthcare workforce. Incentives in the act will also increase the number of health care workers in medically underserved areas and increase and enhance training of faculty in training institutes. In addition, new models of care delivery and reimbursement to improve the coordination of care for patients will be established (Michigan Center for Health Professions, 2010).

The United States already has a shortage in access to primary care, and with healthcare reform, an additional millions of newly insured people will be seeking healthcare.

To target this issue, the ACA has made a large investment to create and increase the number of federally qualified health centers to deliver lower cost, higher quality primary care services to medically underserved populations. Health care reform has a large focus on improving quality, safety, cost, and access to care. There is also an increased focus on prevention, coordination, chronic disease management, health information technology, and patient-centered medical homes which utilize multidisciplinary teams.

Nurse practitioners can contribute as primary care providers, and provide a unique perspective to the underserved population. Increasing funding to APN’s can lead to improved care and outcomes for patients (Flinter, 2012).

To help prevent a shortage of PA's, programs that have graduates entering into primary care will receive grants. To compensate for a lack in nursing, student loans will be paid off if people go to school to become nursing educators.

Physicians are being overworked, and the new bill will attempt to establish "Team Medicine." This will help provide better health care for patients and make doctors happier and less stressed.

Medicare will also pay hospitals that perform better in regards to their patients and limit the number of their readmissions to the hospital. They will also reduce the Medicare payments that the hospital has to make (Washington Post, 2010).

The ACA has also created grants for public health schools and public health training programs, and will increase the supply of nurses by establishing better student loan funding, expanded eligibility for advanced practice nursing grants and creation of a nurse retention grant program.

In addition to physician’s assistants and nursing, the ACA also provides incentives to increase the quantity of direct care workers, including nursing assistance and aides, home health aides, and personal and home care aides. Incentives have also been created to support training programs for dentistry and mental and behavioral health education and training (Michigan Center for Health Professions, 2010).

The Act has also established the National Health Care Workforce Commission to assess need for healthcare workers and identify national workforce priorities. This will help health care workers work more efficiently and provide patients with more equal and reliable access to care (Ormond & Bovbjerg, 2011).

The Commission was created to serve as a resource for the government to communicate and coordinate with departments on multiple levels, evaluate education and training, identify barriers to improved coordination at federal state and local levels and address them, and create ideas to address population needs, technology growth, and other factors. The Commission will allow better collaboration between physicians, nurses, and other health care professionals, which will benefit both health care workers and their patients (U.S. Government Accountability Office, 2010).

Healthcare reform will continue evolving, and ACA has already begun creating improvements in the health care system. Many issues have been addressed and only time will tell whether the provisions, grants, and incentives established by the Act will maintain in the future.

References

Flinter, Margaret. (2012). From new nurse practitioner to primary care provider: Bridging the transition through FQHC-based residency training. Online Journal of Issues in Nursing, 17.1. 1091373

Michigan Center for Health Professions. (2010). Assessing the impact of health reform on the health care workforce. Lansing, MI: Public Sector Consultants Inc.

Ormond, B. & Bovbjerg, R. (2011). Assuring access to care under health reform: The key role of workforce policy. Washington, DC: Urban Institute.

U.S. Government Accountability Office. (2010). GAO announces appointments to new national healthcare workforce commission. Washington, DC: U.S. Government Accountability Office.

Washington Post. (2010). Landmark: The inside story of America’s new health-care law and what it means for us all. Washington, DC: The Washington Post.

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