Access Health Care

With the passing of the Health Care Reform Act, employers will be dealing with America’s health brokers in a different way. Many of the provisions for larger business employers (over 100 employees) will remain very similar to the status quo, but there will be a few changes that may be beneficial to the employee.

SEC. 311. HEALTH COVERAGE PARTICIPATION REQUIREMENTS

(3) CONTRIBUTION IN LIEU OF COVERAGE- Beginning with Y2, if an employee declines such offer but otherwise obtains coverage in an Exchange-participating health benefits plan (other than by reason of being covered by family coverage as a spouse or dependent of the primary insured), the employer shall make a timely contribution to the Health Insurance Exchange with respect to each such employee in accordance with section 313.

What this means is that the employee can opt to enroll in the business health insurance plan, or the employee can opt to seek a more affordable health insurance plan by seeking out a prospective deal through America’s health care brokers via the exchange. The details of the exchange have not been thoroughly set, as of now, but the direction of it is leaning towards a state to state variance where many of America’s health brokers compete to offer health plans at an affordable price.

It may be in the employee’s best interests to enroll in an employee medical insurance plan, because group health insurance will always be more affordable than individual health insurance. Another alternative would be to collaborate with a group of individuals to create an affordable group health insurance plan through the exchange.

A key point of interest for employees who work for a large company (over 100 employees), and are seeking health insurance coverage, is that their health insurance premium will automatically be covered by “not less than 72.5% of the applicable premium” {SEC. 312(1)(A)}. For spouses and children, “Not less than 65% of such applicable premium of such lowest cost plan” {SEC. 312(1)(B)}. As far as family health insurance plans go, it may be difficult to find a medical benefit plan that through the exchange that can compete.

By the year 2014, it will be required by law for every U.S. citizen to have personal health insurance coverage. Those who do not conform will be penalized for it. In order to reduce the problem with big businesses, there is a section that requires auto enrollment by employers. With the progression of smaller businesses merging with larger corporations, there is security in knowing that health insurance benefits are ideal for larger corporations. No longer will pre-existing conditions be a cause for non-enrollment or discontinuation of an existing plan.

America’s health brokers will have a much larger consumer base when the new law takes effect, which means that not only do the consumers win, but they do as well. In an era of sweeping change in the health care industry, group health plans will be beneficial to all who are involved. They will be beneficial to either a personal health plan as well as a family health plan. America’s health brokers will have a number of new avenues, but the greatest prospect will still be with larger businesses.

You need someone you can count on, a health life insurance company that will work for you in your best interest. America’s Health Brokers is that company. We tailor our plans to fit your needs, regardless of your budget. Our partnerships with many A+ rated companies allow us to provide you with a variety of options offering financial flexibility. Plus, we are the only company that offers a concierge customer care plan with all of our plans.

In 2007, the governor of Minnesota proposed a mental health initiative and the legislature passed it. One of the more important components of the initiative was legislation amending Minnesota’s two programs for the uninsured – General Assistance Medical Care and Minnesota Care – to add to the comprehensive mental health and addictions benefit.

Who Is Covered?

General Assistance Medical Care covers those with income at or below 75% of the federal poverty level who meet one or more of additional criteria known as General Assistance Medical Care qualifiers. Qualifiers include waiting or appealing disability determination by Social Security Administration or state medical review team; or being in a homeless or live in shelter, hotel, or other place of public accommodation.

Minnesota Care covers children and pregnant women, parents, and caretakers up to 275% of the federal poverty level, except that parents and caretakers gross income cannot exceed ,000. Single adults without children increased to 200% of federal poverty level by January 1, 2008 and will rise to 215% of federal poverty level by January 1, 2009.

What Services Are Covered?

For Minnesota Care, there are limits of ,000 on inpatient care for any condition (physical, mental health, or addictions) for parents over 175% of federal poverty level and childless adults. For General Assistance Medical Care, inpatient benefits are fully covered. Both programs cover chemical dependency outpatient services. An intensive array of outpatient and residential mental health services are available.

What Is The Cost?

In Minnesota, the Medicaid Temporary Assistance for Needy Families population, General Assistance Medical Care and Minnesota Care are enrolled in comprehensive nonprofit health plans that are responsible to deliver and are at risk for the entire health benefit, including behavioral health. Adding mental health rehabilitative services (including adult rehabilitative mental health services individual and group rehabilitation services, assertive community treatment, intensive residential treatment and mobile and residential crisis services) to Minnesota Care was projected to cost .40 per person per month. For General Assistance Medical Care, which includes a homeless population, the cost was .01 per person per month. The additional targeted case management service was projected to cost .22 per person per month for Minnesota Care and .66 for General Assistance Medical Care.

The legislature appropriated a total of million in additional state dollars in fiscal year 2008 and $ 3.5 million in fiscal year 2009 to add the adult rehabilitative services and case management in Minnesota Care. State funds previously targeted for case management were moved from the counties to the state in an amount of .4 million in fiscal year 2009.

What Led To Comprehensive Coverage?

The state collected data on the residents served by Minnesota Care, General Assistance Medical Care, and Medicaid managed care plans serving non-disabled populations, and discovered that an increasing number of individuals with serious mental illnesses were in these plans. Several insurance reforms – similar to those included in the national healthcare reform bill – modified the private market, including guaranteed issue in small and large group plans, broader rate bands, parity for mental health and chemical dependency services, medical loss ratios, high risk insurance pool, and others. A lawsuit by the attorney general called attention to health plan denials of payment for court-ordered treatment, for example for civil commitment or out of home placement for adolescents.

Health plans settled with an agreement that behavioral and mental health benefits would be covered by a health plan if the court based its decision on a diagnostic evaluation and plan of care developed by a qualified professional. In addition to the court-ordered services provision, the state contracts and capitation with prepaid health programs (Minnesota Care and General Assistance Medical Care) were amended to align risk and responsibility for services in institutions for mental illnesses, 180 days of nursing home or home health, and court-ordered treatment. There were also highly successful experiments reducing costs and improving outcomes for commercial and non-disabled Medicaid clients who were offered a more intensive community based mental health service that improved coordination with and linkages to behavioral healthcare, primary care, and other needed services.

These demonstrations produced a positive return on investment – .38/person/month – and gave the health plans tools to manage the increased risk that resulted from several insurance reforms, including parity, a statutory definition of medical necessity, and the court-ordered treatment provision.

The state supported comprehensive coverage because it sought to provide mental health and addiction services in Minnesota as part of mainstream healthcare. Minnesota’s mental health agency and other stakeholders desired to move mental illness from its historical treatment as a social disease requiring social services to an illness like any other. They wanted to foster earlier interventions and avoid shifting enrollees among different programs in order to access specific services. Operationalizing this change required rethinking medical necessity determinations, provider credentialing, contracting, procedure codes and other processes common to private insurance plans.

How Did It Get Through The Political Process?

Three factors significantly contributed to the political viability of a benefit expansion in the Minnesota Care and General Assistance Medical Care programs:

>> The governor of Minnesota and the administration provided strong leadership. The provisions to expand the mental health benefits in these plans were part of the governor’s mental health initiative, set forth in advance of the 2007 legislative session.

>> An extremely strong coalition of stakeholders formed a mental health action group. This group is co-chaired by a representative from the department of human services and included representation from the private insurance industry and organized and knowledgeable advocacy and provider communities.

>> There was strong support in the legislature for the expansion of benefits in Minnesota Care and General Assistance Medical Care, including from a member of the finance committee in the house, who has a son with schizophrenia. The creation of a mental health division in the health and human services policy committee also helped move the policy discussion forward.

Why Does This Approach to Healthcare Reform Work?

A recent survey of community behavioral health organizations found that on average, 42% of reimbursement for services came from private insurers. While this represents the average, the survey found that there was quite a range in reimbursement sources. For community behavioral health organizations that specialize in services such as Assertive Community Treatment or case management, Medicaid is the predominant reimbursement source, either through fee-for-service or managed care.

Reimbursement from private insurance and Medicaid managed care is uniformly better than Medicaid fee-for-service. In addition to higher rates, the private insurers and Medicaid managed care organizations have been willing to offer special contracts for packages of services for crisis care and hospital discharge plus aftercare.

Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in lobbying for mental and behavioral healthcare reform. Lean more at http://www.thenationalcouncil.org.

The new Patient Protection and Affordable Care Act (PPACA)–otherwise known as healthcare reform–brought relief to many senior citizens for whom preventive care is so critical to their good health. PPACA brings many advantages for seniors on Medicare, one of which is annual preventive care exams. Preventive care on an annual basis means early identification of disease and greater opportunity for treatment and recovery.

Beginning in September, 2010, new Medicare insurance plans and some current plans (specific changes must be made in order for them to be qualified) will begin coverage for specific services like colonoscopy and mammography. Seniors who show evidence they need the tests, and whose doctors order them, will be able to get the services. Beginning in January 2011, other requirements fall away and the services will be available as preventive care with no copay or deductible applied.

Many elderly have been subjected to high copays and deductibles for preventive care services like colonoscopy and mammography. Some were not covered at all. Older adults have a much higher risk of developing cancer, diabetes, aging-eye disease, cardiovascular disease, hypertension, depression, than the younger generations; as a result, the need for preventive services increases with age. Improved coverage means older and more vulnerable seniors will have access to preventive services starting in 2011.

Seniors and their medical professionals are now free to make appropriate choices about medical care based on the need for preventive services, not whether or not the elder can pay for the service. Many senior citizens have had to choose between food and shelter or medical care; they are on poverty level fixed incomes. They will no longer have to make this abhorrent choice, thanks to healthcare reform and affordable coverage for everyone.

Article provided by Sharon Shaw Elrod. Senior Citizen Journal provides current and relevant information on topics of interest to seniors. Please visit my web site at http://www.seniorcitizenjournal.com/.

With the health care debate raging in the United States, many experts have already forecasted many possible scenarios for what could be the end result, but are they accurate? As lawmakers continue to wrestle over such issues as the public option, and extending coverage to the uninsured, there is no debate that the government is looking to cut costs in the health care system, which could spell trouble for the pharmaceutical industry.  The pharmaceutical industry knows that with health-care reform on the way, the prescription drugs industry will be the first to get the axe, losing major pricing power, especially in the Medicare market.  While it is still up in the air whether a public option will pass, the pharmaceutical industry knows that a strong government controlled pricing plan spells big problems for the industry.

Even though the pharmaceutical industry has reason to be concerned, according to some pharmaceutical sales consultants all over the country, health care reform is not all bad news.  Because of the 46 million uninsured U.S. citizens likely to get some form of health care in the next 5 years, that equates for big profits for the pharmaceutical industry.  With more insured Americans getting more access for branded and generic prescription drugs, this will only mean more business for drug makers and a boost in demand.  But the pharmaceutical industry is not so convinced.  Because half of large drug company sales come from overseas, they see this boost as being inconsequential to the money they are going to lose on the federal price gauging that is likely to take place.

Here are some possible health care scenarios, some which may be good for the pharmaceutical industry, some which could even be disastrous.  One scenario is that the government will use its buying power, through Medicare programs, to demand lower drug prices from the pharmaceutical industry.  This program could lower the drug prices in Medicare up to 15%, with the burden of cost falling directly on the pharmaceutical companies.  However, with Medicare only representing about 20% of drug spending in the United States, and roughly half that world-wide, it would only amount to about a 2% decrease in the cost of pharmaceutical drugs.  However, this is not the only scenario.  Some expect that with the increase in coverage from formally uninsured citizens, the government will demand Medicaid pricing for this group, possibly slashing prices of U.S. drugs up to 10%.

Even though the pharmaceutical companies support health care reform, they may not be eagerly supporting a nationalized health care plan.  A nationalized plan, although unlikely at this point, could cut prescription drugs up to 15% even to 30% if the national plan offers very little choice for consumers.  Under this worst case scenario for the pharmaceutical industry, they could see their stock values fall up to 40%.  Any pharmaceutical consultant will tell you this scenario is unlikely, but it is speculations like these that fuel the passion and uncertainty that has become the health care reform debate.  Only time well tell.

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Pharmaceutical consultants – http://www.smartconsultinggroup.com/

Background:

Even with a bill passed in both houses of Congress, Healthcare reform and the issue of a universal or national healthcare system continues to dominate discussions on the hill. There is talk of repealing the bill and potentially leaving millions more Americans vulnerable and uninsured. Some argue that repeal is for the best because the current bill gives the government too much power and circumvents our individual rights and freedoms. Still others argue that the bill does not go far enough to grant every single American the right to healthcare services. These views are polarizing both the Representatives on Capitol Hill and their constituents who live on main-street.

Nurses and physicians work in the field taking care of the insured, the under-insured, and the uninsured. These healthcare professionals see first-hand how the ability to pay for healthcare services shape people’s perception of illness and their willingness to seek medical assistance in a timely manner. Given how highly charged the issue is, it is important to know what these nurses and doctors think of all the hoopla that still surrounds the issue of healthcare.

Healthcare Workers’ Viewpoint:

The opinions in this article are those expressed by the nurses and physicians at a Dallas hospital. For confidentiality reasons the names of said nurses and physicians, as well as, the name of the Dallas area hospital where they work will not be used. Based on their experience in the system, these healthcare workers pointed out their frustrations with the current system, reform, and universal healthcare. The issue is healthcare reform and universal healthcare. How do nurses and doctors view this?

CONs:

On the other hand, there are some nurses and physicians who vehemently oppose the idea of universal healthcare and reform that have been passed. These healthcare workers state the following:

Healthcare is not a right. It is the responsibility of each individual to work hard and pay for the care they require. Many people do not think their hard earned money should be syphoned to take care of individuals who are not pulling their own weight. A system that provides healthcare for all rewards people who are not contributing members of society. Even more, those who oppose healthcare reform and universal healthcare insist that it is not their place to take care of individuals who are lagging in their duties to self and society. These people become a drag on the system. Universal healthcare encourages the weaker members of society to stay weak and non-productive. If people had to pay for the services they receive, they are motivated to find work and everyone wins.
Paying for such a system will require an increase in taxation. This means more money taken from hard working Americans; money they can use to take care of their families, co-pays and deductions, as well as anything they think necessary. Increased taxation also limits funds available during retirement.
Some physicians and nurses believe that Medicare is a blithe on the healthcare system. In a free market society, insurance companies should be allowed to compete freely without a government run system that undermines the free market. Ideally, a free market will take care of pricing and completion will reduce the overall cost of healthcare. Hospitals and insurance companies that meet the demands of society will prevail. People who work hard will have access to healthcare services.
It is common knowledge that physicians in the United States earn more than physicians in other industrial nations. Extensive training and hard work is rewarded by respectable pay checks. Many worry that their living standards will drop if a national healthcare system is passed. Moreover, current reform advocates preventative care which may live certain specialties out of the loop. After years of training to be of service to society, these specialties may become obsolete.
Many people like to know that if they are insured, the care they need will be available to them when it is needed. It is perceived that extending healthcare benefits to all will lead to long waiting lines and if this were the case, many individuals are rightfully afraid of the cost to their lives and quality of living.

PROs:

Patients are more likely to get preventive care if they are insured. Healthcare services cost a lot of money. Many people have been bankrupted as a direct result of their inability to pay medical bills, which include hospital stay, physician and auxiliary care visits (home health nurses & therapists), as well as, pharmaceutical aids and medical supplies. This means that the health and financial well-being of patients are affected by any laws that offer improved access to healthcare services.
Preventative care saves hospitals and tax-payers money. Although not a primary concern for nurses, they were quick to point out that the under-insured and uninsured patients who make it to the hospital only arrive when they are so sick that they may never be completely healed from a disease that could have been prevented with the right out-patient care. Due to the advanced progression of their illness upon admission, these patients stay longer in hospitals and respond less to conventional therapies. The result is a very high cost for the care provided. Since these individuals cannot pay, in many instances, the hospitals are stuck with the bills. In order to pay off debts accrued the hospitals increase the cost of care for those who can pay. It is a logical solution that now affects law abiding tax payers which could have been prevented.
People that are chronically ill cannot work and pay for healthcare. Some end up homeless and become society’s problem relying on assistance from private parties or city government. If everyone was insured, many people who require frequent medical care will be taken care of, thus reducing the number of homeless people in society.
The U.S. is the only industrial nation that does not offer healthcare coverage to all its people.
In a system that relies solely on profit motivated insurance companies to provide compensation, access to certain needed therapies become limited if they are not approved by the patient’s insurance company. These used to be most prevalent with the introduction of HMOs and have since improved. Still it is a stain many organizations prefer not to discuss. As people whose sole reason for being is the care of patients it is no wonder that many will like a system where compensation did not play such an indelible role.

Conclusion:

Overall, during the interview process that led to this article, it became apparent that most healthcare workers opinions on access to healthcare were greatly influenced by the role they played in the care of their patients. It was quite apparent that the nurse’s role as patient advocate greatly influenced their view on healthcare reform and a universal healthcare system. An overwhelming number of nurses were in support of a system that offered coverage to every patient that walked through the hospital doors. Physicians, who were more likely to voice concerns over structure, efficacy, and compensation, were less likely to provide support of a system that will drastically change the existing landscape.

SOURCE:

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Sonya Justice is a seasoned nurse, publisher, and speaker. Her magazine Fabulous Nurse celebrates the nurse’s life and offers insights into the field of nursing. Find Fabulous Nurse magazine on Facebook. She also publishes the online magazine, Pacific Writer’s Corner, which offers a multitude of information for writers. Articles in Pacific Writer’s Corner are written by writers for the benefit of other writers. Sonya Justice is always to happy talk on subjects that relate to nursing, wellness, entrepreneurship, and publishing.

“Never underestimate the power of a small group of dedicated people to change the world. Indeed it is the only thing that ever has.” Margaret Mead

This is an unprecedented year for transformational health system change. It is not only important for nurses to be involved – it is Critical!

The illness care system is in crisis. People seek basic health care in hospital emergency rooms, 51% of the American population takes medication, and our greatest killers, obesity and lifestyle diseases are escalating. As treatment costs rise exponentially, the number of people covered by health insurance is decreasing. Often modern illness care results in financial bankruptcy. These trends are disastrous.

Additionally, the current economic down turn requires that solutions be radical, cost-effective and immediate in order to turn the tide.

The system cannot survive if we continue to focus exclusively on a medical model of symptom diagnosis and treatment. The trends demand a radical shift toward helping people learn how to become and stay well.

What profession focuses on helping people become and stay well? Nursing! With the overwhelming mandate for change demanded by our recent election, a window of opportunity is open for health system evolution. Not a revolution that throws out the medical model, rather an evolution that expands the system to include a continuum of care supporting and promoting health from birth through the life-span and transition into death.

There will never be a more critical time for Nurses to Show-up, Speak-up and Step-up to Make a Difference for the Health of America. If you are ready to seize this unprecedented opportunity to influence how the health system evolves, now is the time.

Now is the Time to Show-Up as a Leader.

Nurses led every major health reform in history. Nightingale reformed hospital and battlefield health. Lillian Wald began reforming public health as a nursing student, later establishing the Henry Street Settlement to provide care to the poor and immigrant population. Mary Breckinridge, a nurse-midwife, reformed maternal-child and family health by founding the Frontier Nursing Service, educating and employing nurse-midwives, and establishing family care centers in the Appalachia Mountains. Margaret Sanger reformed reproductive health and Dame Cicely Saunders, known for her role in birthing the hospice movement, emphasized the importance of palliative care.

Today, nurses are showing up to lead by creating innovative health care delivery models and shaping public policy.

Now is the Time to Speak-Up as a Nurse.

Nurses once again rank #1 as the most trusted professionals in the annual Gallup Poll. Talk with your public. They want to know what you think. What nurse has not received a call at all hours from family and neighbors asking for advice or counsel before seeking medical care?

Nurses comprise the largest number of health care providers. The mandate of our license is to serve the public and advocate for safe, effective and accessible health care. Let the public hear your views.

Speak up with other nurses. Share your concerns and ideas as colleagues and team members. Form a nursing mastermind group to refocus your practice on health and create innovation together in whatever nursing arena you practice.

Speak up with your legislators, the people who decide the scope and limits of your nursing practice.

Now is the Time to Step-Up as a Professional. If the purpose of nursing is helping people become and stay well then nursing is about not only attending patients in hospitals and other tertiary care settings. Only 3% of the population is in an institution. The other 97% needs nursing in the form of primary care, health education, health coaching and wellness.

Who will decide the future of Nursing and Health Care? Your Legislators will!

When I was President of the WV Nurses Association, I learned that the only thing more important than big money in influencing legislators is big numbers.

We sent out the Call and Nurses Showed-Up in record numbers to Unite at the Legislature. These nurses filled the galleries of the House and Senate to overflowing. As a result, we were able to support the passage of three bills including landmark needle stick and mandatory overtime protection, and block a fourth, which allowed unlicensed personnel to dangerously perform nursing functions. The legislators heard the nurses’ message loud and clear!

The nurses, who Showed-Up, Spoke-Up and Stepped-Up for that challenge protected the public and the ability for all nurses to practice safely and effectively.

Will You Show Up as a Leader to meet today’s challenge of health system reform, Speak Up as a Nurse to advocate for the health of all Americans and Step-Up as a Professional to articulate the cost-effectiveness and need for expanding access to professional nursing care?

Borrowing from our President-Elect – “Together, We Can”!

© 2008 Aila Accad

Aila Accad, RN, MSN, past president of the West Virginia Nurses Association, is a professional Nursing Speaker, Author and Well-Being Coach, who presents innovative Nurse De-Stress & Leadership Programs. Learn more or contact her for speaking or coaching at: http://www.ailaspeaks.com where you can sign up for her complimentary De-Stress Tips & News and “Ten Instant Stress Busters” e-book.

There were not any easy choices in the Patient Protection and Affordable Care Act (“PPACA”)as amended by the Health Care and Education Affordability Reconciliation Act (“HCEAR”), except perhaps the opportunity to stick it to the perpetually tanned Rep. John Boehner (R.Ohio), by imposing a 10 percent excise tax on tanning salons using ultraviolet lamps. The Congress did impose a 2.9 percent excise tax on the sales of medical devices which is expected to raise OB in revenues to fund the expanded coverage of health care reform. (The original proposal was for B.) (See section 9009 of the PPACA and section 1405 of the HCEAR) In addition new rules on proof of safety first and the implementation of “effective research” requirements are expected to further raise the cost of doing business in the Medical Device field.

One of the hallmarks of American health care has been the speed at which innovation in medicine reach the market. Americans are early adaptors of new technology. The hunger for new cures and new technology has been a significant driver of health care costs as well as a spur to faster, better and safer interventional products. The Edwards Laboratory heart valve replacement through catheterization being tested by the FDA is such a transforming device.

The imposition of greater regulatory oversight and the imposition of an excise tax that is expected to reduce manufacturer profits by a sixth could substantially restrict start up medical device company access to capital and substantially consolidate and compress the industry, not to mention limit public access to medical innovation. The tax will go into effect in 2013 and will be imposed on everything from defibrillators to bed pans. Fortunately some medical products have been spared. Condoms, eyeglasses, contact lenses, tampons and hearing aids are spared, but stents, valves, insulin pumps and the like will be impacted. The industry will reap the benefit of greater coverage and therefore greater sales, but it is staring at its own looming excise tax “donut hole” in its profits as American health care undergoes its overhaul. Expect a lot of lobbying to kill off this tax before 2013.

[http://dpc.senate.gov/dpcdoc-sen_health_care_bill.cfm]

It’s time to tune out the misinformation mission when it comes to health care reform. The political battle is over and President Obama and the Democratic party won. Health care reform is now the law of the land. The important thing now is that all Americans become informed about what this actually means for them and that’s what this article aims to do with these five facts.

Fact #1: More Medicare Benefits

A big part of the Republican party’s fear campaign on this bill was that it would cut Medicare benefits for seniors (and of course there was the “death panel” lie but that’s too ridiculous to even consider.) The truth is actually the opposite. Because of this bill people on Medicare will have access to new benefits.

There will be an immediate 0 rebate for those who hit the “Donut Hole” this year and beginning next year there will be a 50% discount on all name brands in the “Donut Hole.” By 2020 it will be closed entirely.

But that’s not the only benefit, another big one is that beginning next year there will be no more co-pays for any preventative care visits! This will enable seniors to go to the doctor without having to worry about what it costs them because it will be free.

The bill also “balances the books” for Medicare through at least 2026.

Fact #2: This Bill Cuts The Deficit

Not only is this bill paid for, it actually cuts the deficit. It cuts the deficit by 130 billion dollars over the next 10 years and most impressively it cuts it by 1.3 trillion dollars over the next 20 years.

Fact #3: It’s The Biggest Tax Cut For Small Businesses In History

Yes. You read that correctly. Available immediately will be new tax credits which will pay up to 35% of the health insurance costs of employees. By 2014 that number will be up to 50%. This will be a huge tax cut for small businesses so when the Republicans are running against this bill they are running for a huge tax increase on small businesses.

Fact #4: Denying Coverage Due To “Pre-Existing Conditions” Is Made Illegal

Because of this bill it will be illegal for health insurance companies to deny coverage to children due to pre-existing conditions as of September (6 months after the bill became law.) In 2014 this law will go into place for adults too.

Prior to this bill, it was entirely legal for a health insurance company to deny coverage to a newborn baby with a “pre existing condition.” When the Republicans are running for repeal they are running for making that legal again.

Fact #5: 32 Million More Americans Will Get Health Care Coverage Because Of This Bill

Those running for repeal are running to kick 32 million of our fellow Americans to the curb regardless of how sick they are. That is truly “Anti-American.”

Health Care Reform may have been scary (due to Republican lies about it) to some people in the abstract, but in reality it will be a huge positive for the vast majority of Americans. The Republican party deserves to be held accountable for the lies they told about health care reform. They put their party ahead of the American people and that’s unacceptable.

Men’s Health Blog.

As the debate about health care reform wages on, doctors and patients face similar challenges. Struggling through the difficult language in the reform bill, physicians wait with bated breath to see whether the new system will truly solve some of the recurrent medical issues in the United States. Some changes, such as electronic medical records, have already had a positive impact on healthcare delivery. As a family physician, however, I feel anxious about the declining patient-to-physician ratio as more individuals seek healthcare and less medical students choose to practice primary care. Healthcare reform must address not only what rights an individual has to healthcare, but also how he or she will have timely access to medical care.

Working at an urgent care center, I understand the importance of immediate, personalized care. Today, many individuals opt not to go to the doctor because of obstacles such as scheduling an appointment and finding physicians who accept their insurance. With an urgent care center such as PromptCare, patients skip many of the hurdles of seeing a traditional general practitioner. These sorts of centers often become a primary link to those who most need acute medical attention in the local community. At such centers, medical professionals administer a higher level of care when they can access a patient’s records electronically, granting immediate access to his or her medical history. The current push for electronic records allows doctors to maintain the highest quality and safety standards for medical attention. This emphasis on patient-centered care must remain one of the driving forces behind healthcare reform. Patient-centered care means integrated services from general practitioners, specialists, and hospitals. The more these professionals communicate about the patient, the better care the patient receives.

With a new Congress already debating about the recently passed healthcare reform legislation, many physicians worry that this patient-centered focus may be lost. President Obama’s reforms certainly provide a higher level of access to quality healthcare services, but the government must do more to encourage current students to pursue careers as healthcare providers. Affordable access to healthcare misses the mark when patients must wait weeks to see a physician. As more individuals receive medical insurance, the demand for timely provider access also increases. Unfortunately, the number of students choosing to pursue careers in family medicine has fallen in recent years and the thought of meeting a rising demand overwhelms many physicians who are currently practicing.

Medical students may look at specialties as better opportunities for higher income than the potential income earned in the practice of primary care. When faced with mounting debt, the choice of practice sometimes is motivated by income potential and the realistic ability to retire debt. Reform measures must take these issues into account in order to create a sustainable healthcare system in the United States.

Dr. Lamont Tyler currently serves as Medical Director at OSF SJMC PromptCare and routinely shares his health care expertise through comprehensive lectures and a variety of training programs.

Universal health care seems to be a hotly debated topic whenever health care reform in the United States is discussed. 

Those who maintain that health is an individual responsibility do not want a system that requires them to contribute tax dollars to support fellow citizens who do not act responsibly in protecting or promoting their own health. They argue that they want the freedom to choose their own physicians and treatments, and suggest that government cannot know what is best for them.  These people argue that preserving the current system with improvements to provide better insurance coverage for citizens who remain uninsured or under insured for their medical care needs is the only reform that is needed.

Those who believe health care is an individual right support a universal health care system with the argument that every citizen deserves to have access to the right care at the right time and that a government’s responsibility is to protect its citizens, sometimes even from themselves.

Two opposing arguments arising from two opposing ideologies.  Both are good arguments but neither can be the supporting argument for implementing or denying universal health care.  The matter must be resolved through an ethical framework.

Examination of the ethical issues in health care reform would require consideration of much different arguments  than those already presented.   Ethical issues would center on the moral right.  Discussion would begin with not “What is best for me?” but rather  “How should we as a society be acting so that our actions are morally correct?”

Ethics refers to determining right and wrong in how humans relate to one another.  Ethical decision making for health care reform then would require human beings to act in consideration of our relationships to each other not our own individual interests.

Examination of some of the common ethical decision making theories can provide a foundation for a different perspective than one that is solely concerned  with individual rights and freedoms. 

Ethical decision making requires that specific questions be answered in order to decide on whether intended actions are good or morally correct.  Here are some questions that could be used in ethical decision making for health care reform.

What action will bring the most good to the most people?
What action in and of itself is a good act and helps us to fulfill our duties, obligations, and responsibilities to each other?
What action in and of itself shows caring and concern for all citizens?

As the answer to all  these questions, universal health care can always be considered the right thing to do.

The United States is in the most advantageous position there is when it comes to health care reform.  They are the only developed country without a national health care system in place for all citizens.  They have the opportunity to learn from the mistakes that have been made by all the other countries that have already gone down the universal health care road. They have an opportunity to design a system that can shine as a jewel in the crown of universal health care systems everywhere. 

However, all ethical decision making is structured around values.  In order for universal health care to be embraced by all citizens in the United States, they will first have to agree to the collective value of equity and fairness and embrace the goal of meeting their collective responsibility to each other while maintaining individual rights and freedoms. That may prove to be the most difficult obstacle of all.

Beverly Hansen OMalley is a nurse with over 35 years experience in nursing education. She is health promotion specialist and is passionate about the necessity to address social determinants of health as part of overall health promotion strategies. She is the owner of http://www.registered-nurse-canada.com where she provides information on the Canadian health care system, the nursing profession in Canada, and the nursing entrance tests for the US and Canada.