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The ACA and Me: A Dispatch From the Trenches

Argonauta: The Beach at My Back/ oil stick on paper, 2010 by Julianna Paradisi

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

“Reality is the leading cause of stress among those in touch with it.”—Jane Wagner

By 2014, up to 30 million Americans will have gained access to health care insurance under the Affordable Care Act (ACA). As a nurse human being, I support increased access to health care. However, it is naive to believe it can be accomplished without sacrifice.

My job is a casualty of the ACA.

But let’s backtrack:

It’s more accurate (but less dramatic) to say that our country’s need of better health care delivery significantly affects my job. Most hospital nurses are familiar with Medicare tying reimbursement to patient outcomes. Further, built into the ACA is a requirement that hospitals expecting Medicare reimbursement form accountable care organizations (ACOs):

Under the proposed rule, an ACO refers to a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:07:22-05:00June 5th, 2013|nursing perspective|6 Comments

Michelle Obama: Health Care Reform the ‘Right Thing to Do’

The full transcript of Michelle Obama’s moving convention speech can be found here.

Here she is on making difficult decisions:

“But at the end of the day, when it comes time to make that decision, as President, all you have to guide you are your values, and your vision, and the life experiences that make you who you are.”

On health care reform:

“When it comes to the health of our families, Barack refused to listen to all those folks who told him to leave health reform for another day, another president. He didn’t care whether it was the easy thing to do politically – that’s not how he was raised – he cared that it was the right thing to do.

He did it because he believes that here in America, our grandparents should be able to afford their medicine…our kids should be able to see a doctor when they’re sick…and no one in this country should ever go broke because of an accident or illness.

And he believes that women are more than capable of making our own choices about our bodies and our health care…that’s what my husband stands for.”

Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:24-05:00September 5th, 2012|health care policy|0 Comments

Campaign-Inspired Hot Summer Friday Thoughts

By Shawn Kennedy, AJN editor-in-chief

Commuting in and out of Manhattan gives me plenty of time to listen to the radio and of course, with Election Day a mere 90 days away, the presidential campaign offers reporters a lot of fodder for commentary. And of course, the evening papers and television stations—both national and local—augment what’s on the radio all day. Here’s a sampling of health care–related campaign news that I’ve heard and read this week.

According to the Kaiser Foundation’s Health Tracking Poll, July figures show that overall, two thirds of Americans support Medicaid expansion under the Affordable Care Act (ACA), but when it comes to whether their own states should expand programs, support drops to less than half (49%), while 43% want to keep the status quo. Importantly for candidates, “four in 10 Americans say they could still change their minds on the law.”

My take: The failure of the Democrats to adequately explain the reforms, together with the misinformation from the Republicans (death panels—need I say more?), are leaving the public confused. The winner in November will be the candidate who can convince the voters that the ACA is either good or bad for them on a person level. (And yes, the economy is now the overriding issue, but health care will keep resurfacing as an emotional and “values” issue in the coming months.)

Senate Majority Leader Harry Reid (D–Nevada) accused candidate Mitt Romney of not paying taxes for 10 years while he was […]

Amy M. Collins, managing editor2016-11-21T13:09:30-05:00August 10th, 2012|health care policy, nursing perspective|0 Comments

About Those Death Panels

By Shawn Kennedy, AJN editor-in-chief

Diana Mason, former editor-in-chief of AJN, wrote a post on July 9 on the JAMA Forum blog that’s well worth reading. In it, she talks about the resurgence of “death panels” rhetoric to stir opposition to the Affordable Care Act (ACA), specifically in relation to the Independent Payment Advisory Boards, which are to issue binding recommendations for controlling costs if Medicare grows too rapidly.

In a nutshell, these boards will determine where to reduce costs. If Congress opposes the plan, it will have to come up with same-size cost cuts if it doesn’t want to institute what the board recommends. The message that opponents of the ACA want the public to hear is that their fates will be determined not by them but by an arbitrary committee.

But IPABs are about reducing costs of programs, not passing judgment on individuals. (As Mason notes, the death panel rhetoric was “declared the “2009 Lie of the Year” by PolitiFact, a project of the Tampa Bay Times and partner news organizations.”)

People should have conversations about how they wish to be treated in their last moments, but these should occur with loved ones and direct care providers and be supported by the legal system. People shouldn’t have to worry that they will be rushed along to death if they’re not ready—in fact, this seems […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-03-28T10:36:14-04:00July 18th, 2012|health care policy|5 Comments

The Affordable Care Act Survives, At Least for Now

Shawn Kennedy, AJN editor-in-chief

Senate roll call, Affordable Care Act/by Kurykh, via Wikimedia Commons

It’s been a couple of weeks now since the Supreme Court upheld the constitutionality of the Affordable Care Act (ACA), and there have been too many articles and analyses to count. The bottom line is that its fate won’t be settled until after the November elections. If the Republicans win the election, the ACA will become the first battleground, as its repeal has been promised by candidate Mitt Romney.

What is concerning is that a great many people pay attention to the rhetoric rather than finding out the facts (remember “death panels”?). This point was well made by political cartoonist Stuart Carlson in this cartoon. It’s hard not to be in favor of many of the provisions—like extending coverage under a parent’s plan for children up to 26 years of age, or barring insurance companies from denying coverage for preexisting conditions.

As nurses, we need to know the facts and go beyond the political rhetoric. We need to be informed for ourselves (anything that has an impact on health care delivery and funding will affect nursing) and for our patients, who will have questions. Get the facts—read the law at the link above, a summary of the law, or the articles we published summarizing how it will affect nursing (our original article, and a 2011 update, both open access until […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:43-05:00July 9th, 2012|health care policy, nursing perspective|2 Comments