The ACA is obviously a bureaucratic nightmare, but it boggles my mind that there is nothing we can do about it. I understand that the cost of health care has been a problem in this country, but the care itself is top notch. Since the passage of the ACA I have witnessed some changes in the health care system and I don't like what I see.
To date the changes are administrative-driven as costs are pared down in preparation for less revenue. The cuts are mostly in personnel, such as shorter hours per paycheck or elimination of jobs. I am wondering what will be cut next. And the cuts must continue. It isn't like it will happen overnight- today there are fewer nurses on the ward and tomorrow all elderly will be banned from care. But, if you compare it to the automobile business in Detroit you can see how a once thriving community based on a profitable industry has been slowly decimated by union and government involvement. The health care industry is showing signs of convulsions and I can not envision its future.
While I can only attest to adverse changes in our region, I wonder if we are a representation of the country. Let me make this personal. My husband was a physician in the military for 20 years and has been in the present hospital-based specialty for 17 years. There were 3 doctors and 6 specialty RNs in his department when he came to this hospital and the department was physician-owned. The department contract went to a corporation 7 years ago and there are now 6 docs and 14 support RNs. Under his present contract, the drs are salaried to work 80 hours per 2 weeks, with no increase in salary unless the profit gains warrant a raise. He loves his work and has no problems with working conditions or salary. Patient loads increase annually without increasing profit for the company (Medicaid/Medicare reimbursements are low.) My husband's work log for the last 2 weeks was 125 hours.
Our state has accepted Obamacare and the additional Medicaid patients will soon be eligible for care. The hospitals were told to expect at least a 1% decrease in Medicaid reimbursements. Our hospital is actively negotiating for a new contract so there will only be 3 doctors in the department, thus cutting costs to reflect the low reimbursements. See the developing pattern? Increase in work load accompanied with decrease in pay. In the short term, there are physicians like my husband (no college/med school debt) who will work extended hours without extra compensation. What about long term? It isn't about us, it is about quality and availability of care.
To date the changes are administrative-driven as costs are pared down in preparation for less revenue. The cuts are mostly in personnel, such as shorter hours per paycheck or elimination of jobs. I am wondering what will be cut next. And the cuts must continue. It isn't like it will happen overnight- today there are fewer nurses on the ward and tomorrow all elderly will be banned from care. But, if you compare it to the automobile business in Detroit you can see how a once thriving community based on a profitable industry has been slowly decimated by union and government involvement. The health care industry is showing signs of convulsions and I can not envision its future.
While I can only attest to adverse changes in our region, I wonder if we are a representation of the country. Let me make this personal. My husband was a physician in the military for 20 years and has been in the present hospital-based specialty for 17 years. There were 3 doctors and 6 specialty RNs in his department when he came to this hospital and the department was physician-owned. The department contract went to a corporation 7 years ago and there are now 6 docs and 14 support RNs. Under his present contract, the drs are salaried to work 80 hours per 2 weeks, with no increase in salary unless the profit gains warrant a raise. He loves his work and has no problems with working conditions or salary. Patient loads increase annually without increasing profit for the company (Medicaid/Medicare reimbursements are low.) My husband's work log for the last 2 weeks was 125 hours.
Our state has accepted Obamacare and the additional Medicaid patients will soon be eligible for care. The hospitals were told to expect at least a 1% decrease in Medicaid reimbursements. Our hospital is actively negotiating for a new contract so there will only be 3 doctors in the department, thus cutting costs to reflect the low reimbursements. See the developing pattern? Increase in work load accompanied with decrease in pay. In the short term, there are physicians like my husband (no college/med school debt) who will work extended hours without extra compensation. What about long term? It isn't about us, it is about quality and availability of care.
