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The effects of the patient protection and affordable care act (obamacare) on america's health care system, particularly on medicare and seniors. It highlights the $716 billion in medicare payment reductions from 2013 to 2022 and the potential unprofitability of hospitals, skilled nursing facilities, and home health agencies by 2050. The document also touches upon the challenges in health care delivery, including the decline in health care professionals and the retirement wave.
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Running head: AMERICA’S FUTURE HEALTH 1
AMERICA’S FUTURE HEALTH 2
“The Patient Protection and Affordable Care Act (Obamacare) makes dramatic changes in the country’s health care system, especially in Medicare, that will seriously affect American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. Obamacare mandates $716 billion in Medicare payment reductions from 2013 to 2022.However, contrary to the way they are often portrayed, these cuts are not aimed at specific instances of waste, fraud, and abuse. Instead, they are across-the-board changes in Medicare payment formulas for a variety of Medicare providers, including hospitals, nursing homes, home health agencies, and hospice agencies. In fact, the Medicare Trustees project that the lower Medicare payment rates would cause 15 percent of hospitals, skilled nursing facilities, and home health agencies to become unprofitable by 2019, and this percentage would reach roughly 25 percent in 2030 and 40 percent by 2050”. (Senger, A.,2013).
This means that it will be more arduous for seniors in accessing health care. In particular, Medicare’s reimbursements for health services would fall progressively below providers’ expenses. Consequently, many providers may not be able to persevere with prevailing negative margins and, therefore, would have to break away from Medicare beneficiaries or shift fairly large portions of Medicare costs to their non-Medicare, non- Medicaid payers. (Senger, A.,2013). This is quite disconcerting to contemplate when taking into account the number of Baby Boomers, who will make their mark on ACA and retirement in health care at the same time.
gaps exist for responding to the health needs of older adults. For chronic diseases and conditions such as Alzheimer’s disease, arthritis, depression, psychiatric disorders, osteoporosis, Parkinson’s disease and urinary incontinence, much remains to be learned about their distribution in the population, associated risk factors, and effective measures to prevent or delay their onset” (The Economist Intelligence Unit Limited, 2009).
Obamacare allows for the possession of a new controlling influence to occur. This may give rise for additional cuts in Medicare through the Independent Payment Advisory Board (IPAB). One of the only significant tools available to IPAB to reduce Medicare spending is to cut physician reimbursement rates. Physicians are already dropping the Medicare program, likely due to constant increasing government regulations and the usual uncertainty about their compensation. The Centers for Medicare and Medicaid Services confirmed that 9,539 physicians who had accepted Medicare selected an alternative over the program in 2012, which is marked more than the 3,700 who left in 2009. With the ominous influence of an unelected new board pressuring them, it is probable that more physicians will choose to drop the Medicare program in future (Senger, A.,2013).
Similarly, the profession of nursing has been affected by, not only the economic crisis the US was facing, but we were also experiencing a critical decrease in licensed nurses. In fact, it does not appear that we will see a predictable change in the future. “As baby boomers age and
the number of people entering the health care system increases, nursing will become increasingly more complex, and nurses will be expected to do more with fewer resources than ever before. At the same time, health care facilities around the country will face a shortage of nurses as older employees retire, and technology will start to play a bigger role in providing patient care” (Senger, A.,2013).
One of the biggest challenges the industry faces is the massive wave of retirement breaking around the country. More than half of working nurses are over 50, which means there will be a lot of empty positions to fill in the coming years as they retire, says Susan Yox, EdD, RN, director of editorial content at Medscape” (Senger, A.,2013). Clearly, there will be a necessity for a vigorous recruitment campaign for both physicians and nurses alike to replenish and restore the balance of our professional medical duties, obligations, and objectives in health care delivery.
Nevertheless, in a review of the literature, it is quite astonishing to find that regardless of what we attempt to do as health professionals we may be competing against the odds. According to the American Nurses Association’s Policy and Provisions of Health Reform Law (2010), the question asked is whether “Health Care is a human right [?]”. Their answer is “No. -While the law extends heath care to many millions more Americans, and protects those who already have coverage from many of the abuses of insurers, the law does not declare health care to be a human right” (American Nurses Association, 2010). In sum, this statement alone violates every goal, objective, rationale, and ethical purpose for our pledge to serve our professions. Obviously, we all have work to do, both in the medical and political realm to serve the health of our nation.
AMERICA’S FUTURE HEALTH 6