In preparation for class, please read over this once or twice.
Just kidding. Here and here are a couple of short documents giving us some more information about this act which has changed and will continue to change the healthcare landscape. I'm not 100% sure which direction you guys wanted to take this discussion when you selected it as a choice, but I'm hoping to keep the discussion away from politics as much as possible. Outside of that, we'll take this topic wherever you would like.
I'm guessing that one of the reasons that this topic was so popular was due to some concern on the public end. What issues do we raise with the law? Do there appear to be expanded opportunities for pharmacists? Feel free to add links in your comments to additional information that will increase discussion and understanding.
25 comments:
I feel that everyone having health insurance is a great idea! However, there is no way to provide quality health care to everyone so I do believe that the quality of care individuals will start to receive will begin to decline. Today, doctors are given minimal time to spend with each patient. If every patient is given health care, then the time and quality of care will drastically decrease. I also believe that individuals should not be forced to give up their health insurance policy to sign up for the policy that meet the guidelines set up by the Affordable Care Act. If individuals like their insurance and it is working for them, then they should be allowed to keep that insurance. I feel that everyone is entitled to health insurance, but I truly feel that the quality of health care that individuals will receive will decline.
Amanda Bradsher
Doctor of Pharmacy Candidate 2017
WUSOP
In the Affordable Healthcare Act, it seems that there is a lot of uncertainty. I think it is hard to say exactly what will happen because of the Affordable Healthcare Act until these measures actually take place. Under the Affordable Healthcare Act there will be a lot more patients under the healthcare system. This will provide more opportunities for pharmacists, because more healthcare professionals are going to be required in order to deal with the increased load of patients. Also, there has been a decrease in doctors, so pharmacists roles are more likely to expand(http://thinkprogress.org/health/2013/10/03/2724601/california-expands-pharmacy-role-obamacare/). Another big point that this law makes is that it makes healthcare available for everyone. However, it seems that this new healthcare plan will not necessarily make healthcare better. There have been rumblings that the Affordable Healthcare Act will cover more people, but will it cover people with very serious illnesses? Robert Goldberg of the NY Times said that because insurance companies' profit margins are decreasing due to the Affordable Care Act that insurance companies' healthcare plans may not cover some of the better cancer hospitals in America ((http://www.americanthinker.com/blog/2013/11/obamacare_victimizing_cancer_patients.html). So this could be really bad for cancer patients if this is true. So the Affordable Care Act will make healthcare available for more people, but is it necessarily better healthcare? That seems to be the biggest issue. Given the information I know, it seems like the Affordable Healthcare Act may be for the worse instead of the betterment of healthcare.
William Joseph Helms
Wingate University School of Pharmacy
Doctor of Pharmacy Candidate 2017
I do agree that the cost of private insurance is a little steep and the Affordable Care Act has good intention in aiming to lower that. However, several issues have already been present with the Act. First, technological errors have already been established concerning the website healthcare.gov. In addition, many individuals' insurance has been either revoked or increases substantially. All in all, the Affordable Care Act has good intentions by helping out those who need it and lowering high costs. I just think that more time and effort need to be placed into the development in order for the plan to be beneficial for everyone. Also, more regulation needs to be put in place to ensure the people benefiting from the Affordable Care Act are actually individuals in need.
I am going to start off by saying that I do not know much about this subject. My interpretations are similar to what some have spoken about today in class. I do not see it deemed fit that people that work hard are having to pay more money, and those that work less or not even at all are reaping the benefits from this program. Obviously, there are always exemptions, but the majority of people are abusing the system. People are not spending there money on insurance, while they are spending there money on drugs. If this program is going to continue, there needs to be a better evaluation of each individual before they can qualify for this.
-Taylor Morrisette
I think my biggest issue with the law is the government control. I know that this isn’t supposed to be political but who decided on all of these laws and rules in the affordable heath care act. It wasn’t doctors and pharmacists, it was politicians. How can non-healthcare professionals make decisions about our healthcare system and then tax the crap out of us as Americans. I also think the grading and reimbursement scale for hospitals is poor. I do not think that it will improve healthcare, I think will make hospitals more conscious of what kinds of patients they take and what services they will provide to keep their rating to get paid. I see this only as an attempt for the government to get more control over more aspects of our lives and I am not a fan. I do think that our healthcare system costs need to get under control, but I don’t think this is the way. Anytime the government gets involved, it’s never a good thing. I think the other negative is the impact on people, the cost for these plans is not really any cheaper than private insurance plans. I was actually talking with my Dad about this the other night and he said the Duke Energy is considering dropping all insurance coverage for its employees and paying the fine. I also think we should look at other country’s healthcare systems. All everyone talks about is Canada and the UK. Their health insurance is funded via taxes and really isn’t what’s it all cracked up to be. I am not a selfish person but I work hard for what I earn and I have a problem with being taxed to death to pay for someone who doesn’t want to better themselves. I also think we should look at Germany. They are desperately trying to get private insurance to compete again because their socialized medicine is almost at the point of collapse. I think all of this things should have been considered and we as Americans should have voted on it, not congress.
Tavie Laws
WUSOP
Although I lack much knowledge on the Affordable Care Act, I feel that the ACA had good intentions initially. However, based on the class discussion and individual comments, it seems to me that the ACA has caused many negative outcomes and is responsible for a lot of stress that Americans face regarding health care and the financial issues associated with it. In relation to one of our previous discussion topics, I believe that everyone should have access to health care and that health care is a right rather than a privilege. Additionally I feel that everyone should have insurance, yet there are obstacles present that prevent everyone from having insurance and obtaining health care. In order for ACA to be effective, I think some extensive revisions are necessary in order for all Americans to benefit.
Kimberly Pullium
Doctor of Pharmacy Candidate 2017
WUSOP
I think that if the ACA is not changed, then it is going to have drastic consequences on the field of healthcare, the quality of healthcare that patients receive, and even larger effects on the economy. Although it will likely allow for increased opportunities for pharmacists, I believe that this benefit does not outweigh the problems that the ACA is going to cause. Also, I think that opportunities are going to increase for pharmacists anyway with the aging baby boomers all retiring and the population of the United States as a whole getting older. I think that the quality of healthcare could decrease in several different ways. First, if doctors start getting paid less for their services, then not as many bright people will want to be doctors. If they know that they can make more money becoming businesspeople, then there is not much incentive to go to school for eight years, become a doctor, and then have to pay back hundreds of thousands of dollars in loans. Paying doctors based on patient outcomes seems like a bad idea to me. Doctors cannot physically force their patients to do anything (unless it is court ordered). If a patient leaves the hospital, but doesn’t take their medicine and gets readmitted to the hospital, I don’t think that is the hospital’s fault and that hospitals should be paid for the services that they rendered. I don’t think that it would take very long for someone to say “we can do that pharmacies too and save money on prescription medications.” The insurance companies could say, “We’ll only pay the pharmacy for a patient’s medications if their pills work for that patient.” So I think that parts of the ACA like patient based outcome payments could lead to hospitals (and one day pharmacies) not getting paid for a lot of the services they provide. People are now also finding out that they are not going to be able to see the same doctor that they have been seeing their whole life, severing the longtime ties between doctors and patients and forcing patients to start over with another doctor. Waiting times for medical services will likely also increase as has happened in other countries like Canada. Another thing is that since the Supreme Court declared the law constitutional because they deemed the ACA to be a ‘tax’, the IRS (Internal Revenue Service) is now in charge of healthcare! I do not think that this is going to be good for patients as I do not think that tax agents should be able to tell doctors or other healthcare professionals how to practice medicine. As for the economic effects, this law is probably going to hurt many more people than it helps. Businesses are already cutting people who were working full time down to part time (less than 29.5 hours) because businesses are not going to be forced to buy insurance for part time workers. So in order to basically give free or almost free insurance to the 40 million people who are currently uninsured in this country, probably far more than 40 million other people are getting their hours cut, having to pay for their own insurance now, and having their insurance rates skyrocket as well. Someone has to pay for the insurance for these 40 million uninsured people under this law, so other hard working people are having this cost passed onto them resulting in much higher insurance costs for people who pay for their own insurance.
Ed Svendsen
WUSOP
Doctor of Pharmacy Candidate
Class of 2017
The affordable care act is going to greatly increase the workload of health care professionals. Nurses and pharmacists could help share some of this workload in order to take some of it off the physicians. However, I do not necessarily agree with the affordable care act because the government is in control when they aren’t healthcare providers of any kind. While I see that it is making insurance available to everyone, I do not think that is always the best thing. There was a good point made in class about making money available to individuals who aren’t responsible, even for their own health care. If insurance companies are required to cover everyone, then the premiums are going to go through the roof. Businesses that have a certain amount of full-time employees are being forced to give health insurance. This is causing hours to be cut because employers cannot afford to offer this and the employees are losing income, on top of not having any insurance coverage. The affordable care act focusses more on making sure that everyone is covered without acknowledging the cost. While part of this affordable care act may be good for some, I think that it has negative consequences as well that may outweigh the good.
Ashley Severt
Doctor of Pharmacy Candidate 2017
WUSOP
I could discuss many parts of the law with which I take issue. I could even discuss the earmarks within the bill, which I wish it did not contain. I am even tempted to delve into how prices of plans have risen and cancellations have occurred, because the market has been removed from the guidance and correction from Adam Smith's "invisible hand." We could all discuss how the federal government cannot even operate a website about healthcare, let alone, get between a patient and his or her provider; however, I won't. These things were all part of my first impression. Above all, I am disappointed. I am disappointed that pharmacists expected to gain much more ground in provider status decisions and challenges to the profession, yet these problems were barely addressed. I was obviously skeptical of how the government artificially spiking demand for insurance and guaranteeing insurance companies the patronage of every US citizen was supposed to lower prices and prevent price gouging. Nevertheless, I am sure many other people were counting on this reform to lower prices so they could afford insurance and were discouraged by the political newspeak and pork barrel spending that took place in its stead.
Michael Russell
Wingate University School of Pharmacy
Doctor of Pharmacy Candidate 2017
I agree with Amanda. Although the idea of everyone having healthcare is good, the quality of health care will decrease as the number rises. Health care professionals will be in higher demand, but their time will be spread thin. I think with anything, rules and regulations need to be set forth to prevent abusers of the system. A student made a valid point in the class discussion about the correlation between the government and health care. Government officials, who may be uneducated in terms of health care, are making executive decisions for the whole entire country. Overall, the idea is good but I don't think the outcome will initially be beneficial.
Carrie Tilton
Wingate University School of Pharmacy
Doctor of Pharmacy Candidate 2017
The sub-title of the article on Affordable Care Act “Objectives and Likely Results in an Imperfect World,” is so apt. While the Affordable Care Act has good intentions and ideas, being in an imperfect world is what may deter the program from being properly executed. The primary goal of the AFC is to reform the primary insurance market, expand Medicaid and to change the way medical decisions are made. All these are honorable intentions, but the question is whether it is achievable. What I believe is that if our healthcare system was working for us in the first place, then, there will be no need for change. So, we should be able to try this option, just like everything in life. If it works we keep it, and if it fails we go back to the drawing board.
Adaobi Obika
Wingate University School of Pharmacy
Doctor of Pharmacy Candidate 2017
After I read the articles it seems that the affordable care act will impose new responsibilities on pharmacists thus increasing their workload. This act provides healthcare for everyone but it may actually decrease the quality of care/treatment. Earlier when we mentioned this topic in class I heard many opinions regarding
people exploiting this act. Patients who don’t take care of their health can keep coming back to the hospital which in turn increases cost for the hospital. At the same time it takes away opportunity from other people who actually do take care of themselves from the opportunity for proper treatment because healthcare professionals are too busy dealing with patients who shouldn’t even be at the hospital. Not only will it decrease quality of treatment but it may decrease healthcare professional salaries.
Pooja Duggaraju
WUSOP
Doctor of pharmacy candidate 2017
The idea behind the Affordable Care Act sounds like a good one, however, I do not see how it could possibly work. There have already been numerous issues with the setup and stipulations associated with the law. I was watching the news and saw where one state had signed up 4 people and it cost four million dollars! I don't see any affordability there. I've also heard of numerous instances where the elderly are being forced to pay ridiculous premiums that they simply cannot afford. I also believe that as a result of this law, the quality of healthcare will decrease. Physicians are already busy enough as it is, if everyone is forced to pay for healthcare and at such expensive rates, they are more likely to want to utilize that at every chance possible. So far I have yet to see any new opportunities for pharmacists as a result of the law. I've seen more responsibilities being placed on the pharmacists, but with no compensation. I also have an issue with the fact that it is the government making these laws. They are not trained in the healthcare profession and have no business regulating it. While the insurance system may have its flaws, it is a free market business and should be treated as such. Overall, the Affordable Care Act is not affordable and will reduce care.
Christi Spivey
Doctor of Pharmacy Candidate 2017
WUSOP
The Affordable Care Act was initiated with good intentions. The goals of the Act are to reform the private insurance market, expand Medicaid, and change the way medical decisions are made. The thought that lowering the costs of health care to individuals and everyone having insurance is a great start. But we must ask, how effective will this Act be? Already we have seen many issues ranging from technology to cost advances with private policies. These issues cannot be ignored. It is great when someone can finally obtain insurance after having a pre-existing condition and repetitively being denied. I am all for helping those in need. However, there are so many people who will be abusing the system, and I feel that they should not be provided with the extra help from us tax payers. Also, why must we change the insurance policies of those who have been paying for a certain policy for years and it is working well for them. It is really necessary to increase their costs, or make them switch plans all together? The thought behind the ACA is a generous and hopeful thought, but not very obtainable. If this plan for everyone to have health care and insurance coverage is to work, there should be much more planning put into the process.
I do not have an extensive knowledge of the Affordable Care Act. The goal of the act seems appropriate but I’m not convinced with the act as a whole. There are several issues that should have been prevented including the website malfunctions, revocation of insurance policies, and raising plan costs. I am unsure if these issues were due to a lack of thorough planning or just unpredictable events but they increased skepticism of an already controversial act. I do think it is important to provide affordable healthcare for everyone but I think other options need to be considered. Additionally, I don’t think the government should force individuals to purchase insurance if they decide not to.
Laura Bowers
WUSOP
Doctor of Pharmacy Candidate 2017
Ed Svendsen covered the points very well. The fact is it will not economically work. Simply put (obviously a more specific explanations with details is required but I'll keep it sort) by increasing the number of people under the "healthcare umbrella" it is impossible to reduce the country's cost of healthcare. More and more people covered equals more and more money needed to pay for their plans. This will lead to a lower price for these customers but a drastic increase in price for the individuals on private plans. This is an argument of the difference in cost and price. When buying a candy bar at a store the price you pay is 2 dollars whereas the cost to make the product is say 50 cents. Now to make the candy bar more affordable to the customer you lower the price to 75 cents. Big cut in profit right? There would be little incentive for the retailer to sell the candy bar at all, unless many outside parties are giving that retailer the extra 1.25 being lost. This is a simplified example of the economic theory as I see it.
Although this is not "economics school" it's pharmacy school and I do see a need for a increase in healthcare efficiency and effectiveness in our society, but this does not seem like the solution. I'm confident however if we healthcare professionals put our heads together we can find the best option.
Jacob Gibson
PharmD Candidate 2017
WUSOP
I am a supporter of the Affordable Care Act, so I see the Law in a more positive way as the perception is more influenced by people's politics rather the real healthcare insurance concern. I am not too thrilled with the insurance drop out and the attempt to get people covered well beyond their needs, after they have been told that their previous coverage would be kept. I really am troubled with that, but it is a way of the insurance companies to fight back. It is their way of concocting with the opposition to get the law to fail, so we can hold on to the status quos. But, although it is disheartening I believe that politics aside, if we wish to make the Law works, it will. Healthcare cost is way out of control, so taking a bold step to deal with the issue should be encouraged rather than dismissed solely on the basis of politics. I am a greater supporter of market economy, but the system isn't perfect as today's mess is solely the result of market economy gone awry.
The American Medical Association as well the AARP, the senior lobby have been the strongest backers of the Law. I think that given sufficient time and opportunity we can see whether the law is effective or not. I know the forces of status quo will push harder to make the law fail, again for political and cultural reasons, but most supporters are relentlessly working to get the issue fixed. I also don't believe the detractors when they say quality of healthcare is going to decline, just because the accessibility becomes more affordable. The US is the only Developed country with no universal healthcare, yet I don't see citizens of countries that do have universal healthcare flooding to America because the quality of their healthcare has dropped since the implementation of universal healthcare. Just here in America, I have not heard that the quality of healthcare in Massachussetts is now lower than let say Mississippi or South Carolina to name the few states that are ardent opponents of the ACA. If we just look at the rants of opposition to the law, we might think that those who oppose the ACA are all in unisson when it comes to having the law to fail. To the contrary a substantial number of people who oppose the law are doing so because they want a true Universal healthcare, with single payer. The ACA is not even close to the system these other countries have, yet we see all the rants that have no other basis but political philosophy.
Other detractors mention that waiting times have increased in countries with Universal care, and I concede that it is happening, but one cannot compare these imperfections, with our failing status quo. There have been one too many stories of American dying in waiting rooms and ER and not being attended to in hospitals. One of the reasons why people oppose the law is that they believe their " tax money," would be helping the most vulnerable among us. Hubert H. Humphrey once said,"...the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped. " If we stop connecting healthcare to welfare, we would realize that without this law in place, we will continue to pick the cost of those who show up and get treated at our expenses in ER all across the country. This law ensures that everyone picks his share.
Etienne.
Like many others have posted, I do not know much about the Affordable Care Act. It seems like a good idea for everyone to be able to have insurance, but I do not think it will be able to work unless some things are changed. Also, it takes forever now for people to be able to see a physician. Imagine a lot more people waiting. Healthcare quality will go down. I feel like many people who do not take care of themselves will abuse the system. I do want for everyone to be able to get the care that they need, but I do not like when people abuse it.
Courtney Harrell
WUSOP 2017
I think the Affordable Care Act, which I will refer to as ACA, is political and unable to reform the health care system. We already have at least three huge federally funded government programs that were implemented to help the needy—Social Security, Medicare, Medicaid—and all 3 of those services are very poorly run and making us, as a nation, bankrupt. Furthermore, there are state services which are in place to help the needy. And if all that is not enough, there are nonprofit organizations including faith-based organizations as well as small business and large corporations who also donate to causes and people in need. If someone is receiving from those services and still unable to afford health care, the problem is with health care cost (not to mention personal spending habits and personal priorities which I won’t get in to) and that’s where the reform and laws should be. Mandating insurance will not make health care affordable, and at this point in time, that is all I know of that the Act is going to do.
If healthcare is expensive because large corporations are “rich” and people are “poor”, then there needs to be a line drawn for those corporations. The corporations are needed for innovation, research and technology, so they cannot be stunted. However, they do not need to be “rich” at the expense of their consumers, who are unhealthy citizens with low income. Also, insurance companies, which are not needed if healthcare is affordable, do not need more money than the consumers they are supposed to be serving. Only with chronic, debilitating illnesses does insurance make sense. And even then, if regular maintenance health care was affordable, people with expensive illnesses would have more money to spend on their long term health than they do currently. The ACA does not seem to be making health care affordable by changing the fee system but by mandating insurance, which will not make health care affordable. If health care was affordable, then we wouldn’t need insurance. So, it makes sense to make healthcare affordable, not to mandate insurance. Mandating insurance will make us pay the insurance company, the HCPs and the government. Instead, let's just pay the HCP in full and the government for defense and maintaining natural resources for everyone and not have to pay a third party.
Kristin Payne
Doctor of Pharmacy candidate 2017
WUSOP
While I believe the intention of the Affordable Care Act was to help citizens and to provide better healthcare, after discussion in class I believe the opposite effect has occurred. The Affordable Care Act started downhill from the beginning; people struggled to apply for healthcare and the systems were backed up for days. Now, many are struggling just to afford the healthcare they are required to have. Not only is this directly affecting the patients financially, but I believe it will also begin to affect the healthcare they receive. Physicians are already constantly busy and running behind. Now that every patient will have healthcare, the clinics must care for them. This can cause an influx of patients into clinics and will inevitably cause the quality of care to decrease. All around, patients are suffering from the Affordable Care Act while healthcare providers are dealing with more patients and the associated paperwork.
Maegan Wells
Doctor of Pharmacy Candidate 2017
WUSOP
The Affordable Care Act is a complete disappointment in my opinion. The more I learn about it, the more frustrated I feel. It’s becoming more like a list of empty promises, and I’m tired of hearing about it. The ACA was supposed to save people money and provide insurance to everyone, but it has just been a complete mess. The ACA has caused more economic strain, rather than lifting the burden. Individual payroll taxes will increase with medical coverage modifications, which will lead to limited use of health care services. The ACA also causes lower hospital revenues and modified physician payments. Also, more people will be reliant on government programs, such as Medicaid. After learning about the Affordable Care Act, my beliefs have been confirmed that government should stay out of healthcare. I think better resolutions could be offered by a team of healthcare specialists. Ultimately, everyone should have access to healthcare at an affordable price, but I do not think the ACA is following through with its promises.
Jordan Richmond
Doctor of Pharmacy Candidate 2017
WUSOP
The affordable care act is a topic that raises many concerns with the public. A lot of people have made the point that the affordable care act is unconstitutional from the very beginning. Their stance was that you should not have to pass an act before you are able to read it, and I believe that they have a point. I believe that most people share the vision that healthcare needs to be reformed, but the affordable healthcare act is not the way to go. I believe that it was rushed through and so far, there have been a lot of problems that have come from it. I don't see how there are any benefits for pharmacists, however I'm not well versed on the issue (who really is?). I know that it's based on a 5 star system and quality and adherence issues. I believe that it will be harder to get paid by insurance companies. So far, it is of my belief that this was the wrong decision and that more discussion should have taken place before we passed a law before we were able to read what it was about.
Christopher Stewart
Doctor of Pharmacy Candidate 2017
WUSOP
Like others, I do not know much about the Afforadable Care Act. I think that the ACA needs to be promoted more so that awareness of the ACA can be increased. They need to figure out the best way to provide information on the ACA. People who are to be enrolled in it needs to be educated in the act itself. I do support the goal of it; however, I do not believe that the goal is being met.
Sheng Vue
Doctor of Pharmacy Candidate 2017
WUSOP
I am basically with the ACA which intends to expand health care service for the low income people. As I am very interested in the equitable health benefits, I hope to see more people have affordable health insurances and be benefited from them for the appropriate health services. Larrat, Marcoux, and Vogenberg’s article helped me understand the possible health service landscape change with the ACA. In particular, their expectation of more broadening roles in pharmacists has challenged my concept of a pharmacist. I used to think that pharmacists’ roles are for the patients only, but have realized that we also need to have knowledge and deep insight on the health care business and law so that pharmacists can confront the changes in the health service landscape.
While there are uncertain areas in the practice of ACA, it is moving forward to practice the affordable health insurance in the coming year. With the limited funding resources, however, there will be controversial power struggles, negotiations, and compromises among those who are involved in the health care business such as hospitals, health insurances, pharmaceutical companies, doctors, and pharmacists. I hope that we are not passively responding to the ACA or the affordable health care issues. Rather, some pharmacists are actively involved in the process of making the ACA or developing it so that we can effectively support the low income patients and maintain high quality of health care service even under the ACA. Through the articles, I have learned the importance of administration and legal capacities in the health care service as well as professional knowledge and skills in public health care as a pharmacist.
Kim Lee
Doctor of Pharmacy Candidate 2017
WUSOP
Affordable Care Act is a law that defines to increase the quality and affordability of health insurance, so on the other hand it is reduce the cost of healthcare individuals. Personally, I am not an expert in knowing the core side of Affordable Care Act. However based on the information that I am aware of I am not convinced the act as a whole. The issue that I would raise with the law would be that a group of law maker who makes law are not healthcare experts. So my view would be that group of people who organize and enforce the law should be an healthcare expert.
Shruti S. Desai
PharmD Candidate 2017
WUSOP
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