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NP & PA Student Blog

An NP Student Reflects on Healthcare Reform

Published July 9, 2012 8:06 AM by Stacey Snodgrass
I know, I know. You're all probably thinking that if you see another blog about the Patient Protection and Affordable Care Act, you are going to need an emesis basin.

Since the healthcare reform package was upheld by the Supreme Court, healthcare is back in the news and on the minds, lips and keyboards of just about everyone. I will attempt to make my two cents short and sweet.

Let me preempt my opinion by first saying that I have not read the act in its entirety (though I have read quite a bit of it), therefore I am openly admitting I am not expert on it. I imagine that in the next few months, I will become much more of an expert on it. I would also like to state that I do believe healthcare in this country needed reform; I am just not entirely convinced this was the way to do it.

My first concern is access. Yes, I know the legislation was created to increase access, but in a system already overburdened and with too few providers (physicians, nurse practitioners, physician assistants, nurses, nurse assistants, radiology techs, etc.), the proposed increase in Medicaid coverage alone will be overwhelming, and that is literally that is just the tip of the iceberg. I fear access is going to suffer.

I worry that when and if I get through this NP program, will I need to see 50 patients a day with restricted autonomy. It seems a bit like putting the cart before the horse. I believe efforts should have been made to increase providers and healthcare workers first, or at least simultaneously. Lifting some of the restrictions on practice would have been a good idea, too.

Another concern I have is the mistrust the passing of this act has created in the public. Mistrust between those seeking care and the healthcare system has been a barrier, and now I feel the mistrust will increase. I fear this mistrust will cause a backslide in the improved outcomes healthcare has worked so hard to achieve in recent years. It seems that for every step forward, there are two steps back.

3 comments

Oops!! The quote should have said "If they healthcare is expensive now, wait till it's free."

Chris, PRIMARY CARE - FNP July 26, 2012 9:34 AM
Greenville SC

Yes my dear. If they healthcare is expensive now, wait till its free!

Chris, PRIMARY CARE - FNP July 26, 2012 9:32 AM
GREENVILLE SC

I agree that this act will probably do less to reform and more to muddy the healthcare waters.  

Three realities regardless about the actual future outcomes (aka things we know and nobody denies)

1) We can't pay for it.  It's still in flux by the CBO.  March it was over 1.3 trillion.  http://www.cbo.gov/publication/43414

2) Doctors will retire.  Who will replace them? http://news.investors.com/article/556398/201012091905/new-poll-confirms-ibds-09-finding-of-doctor-exodus-under-obamacare.htm?p=full

3) Controversial abortion coverage will be implemented funded by the individual mandate, much to the dismay of various religious institutions and moral objectors: http://aclj.org/obamacare/obamacare-abortion-funding-rule-finalized

We'll see!  Bottom line is it is our job as HC providers to treat every patient with our greatest care and concern despite any system we love or hate.

Caroline Pilgrim July 9, 2012 2:37 PM
roanoke VA

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