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Raising the Bar in Rehab

I Don't Know Much About Politics

Published August 23, 2012 5:09 PM by Lisa Mueller

Really, I don't know that much. Politics to me is complicated and deceiving, and by not knowing which reports to trust or even believing any candidate will follow through with his promises, I find myself avoiding the issues more often than not. But as I've grown older and recognized how these elections will ultimately impact my life, profession, and, gulp, money, I find it necessary to start understanding the topics and candidates more thoroughly.

I searched for "Affordable care act summary" online and found the top page of results dating from 2011 and 2010, although I was almost certain the bill was passed just this summer. I went to the White House website and found a general overview of the bill and its benefits. No lifetime dollar limits to coverage, children with pre-existing conditions can no longer be denied coverage, covers for preventive services, prolonged coverage for young adults, and even strengthening the Medicare system. Looks pretty good.

When I hear the word "Medicare," all I know, and most of my colleagues would likely agree -- I think of less reimbursement, and I think of all the other insurance companies who follow that payment model.

On the other side of the coin, the Internet chatter over Mitt Romney's Medicare proposals are not all that complimentary. Romney believes competition and innovation will have a greater impact on keeping Medicare afloat versus Obama's federal administration-dominated plan. Romney suggests placing greater responsibility on state governments to regulate local insurance, promoting free markets and reliance on competition to drive improvements in efficiency and effectiveness, and empowering consumer choice. Sounds pretty good.

I visited the health care page of Mitt Romney's website -- the first paragraph reads in bold print, "OBAMA'S FAILURE." Really? Can't be civil toward each other, can we? I don't understand the blatant finger pointing at the other candidate and wish both parties could maintain a greater degree of professionalism as this election heats up.

Either way, those baby boomers are only getting older and will be flooding our physical therapy clinics very soon. The changes any president can make both to health care and Medicare in the upcoming years will be crucial to supporting our senior citizens. Perhaps the best solution isn't one extreme or the other, but elements of both candidates' proposals.

For the record, I don't consider myself to be either a "Democrat" or a "Republican." I've voted for both parties in the past. I vote for the person I most agree with and who I believe can lead our country best.

What do you think? Do you know much about either candidate? Although the election is more than two months away, have you started researching the opinions of both Mitt Romney and Barack Obama?



Excellent points across the board.  I agree with you, therapists and other health care providers who do not provide high quality care are contributing to the current health care picture.  Outcomes are more important than ever.

I did not watch the webinar but will make time to do so soon.  Thank you for sharing your thoughts.  

Lisa Mueller September 3, 2012 4:19 PM

A Webinar hosted by Advance was just held on August 22, 2012 entitled:  HEALTHCARE REFORM: IMPLICATIONS FOR REHAB POST SUPREME COURT DECISION.   I suggest those who did not get a chance to attend, request to get access to the slides/notes.  The contact person listed for the webinar was:

One point I do remember the Speaker stating was that ObamaCare plans to decrease Medicare B reimbursement for Post Acute intervention by 30%, and a decrease to Physician reimbursement by 2% across the Board.  No more exceptions to Therapy caps also apply.  I believe this is to begin 1/1/13.

Double check my understanding as the Webinar Speaker quickly gave a lot of info in a very short amount of time.

One thing is for sure is that Patients/People need to take more responsibility for their own Health.  They need to make sure they have Insurance if they don't want to pay out of pocket for services, and follow through with exercise and a healthy lifestyle.

Second, many Therapists need to put more effort into their evaluations and treatments for Patients in which they make a good wage to serve.  I have been a Physical Therapist for 14 years, in 4 different States and over 50 different Facilities.  Physical Therapy is my second career, as I ran Computer Mainframes for 14 years in Chicago while completing a B.S. in Computer Science.  I AM of the Baby Boomer generation, which is spoken of will "flood the Market".  But I am a very healthy Baby Boomer taking care of my own health.

I continue to hear from patients that I serve, of how they sought out Physical Therapy before and were given a sheet of exercises and a TBand, and no manual intervention was ever attempted to rehab them.  I hear about Therapists that give the patient an exercise, and then walk away to chit chat with a Colleague regarding personal issues.  I hear about Therapists who give a patient an exercise, and then go sit at their desk and get on their IPhone on Facebook or texting.  Or a Therapist that zeros in only on the joint of pain for treatment, without assessing adjacent joints, postural alignment, etc., and the pain does not resolve. These are frequent stories I hear when manually treating Clients!  SHAME ON THOSE THERAPISTS !!!  A PERSONAL TRAINER CAN DO THAT!  Quit wasting the Patient's health resources!

Somewhere along the line, some Therapists got the impression that since they got a degree and past a State Board, they are entitled to high pay with little effort.  Nonsense!  You must earn your respect.  You are being paid for SKILLED care.   Where are your skills ???

The Therapists who get maximal results in minimal time should be highly regarded and paid.  Those who get poor or little results with extended visits should not be highly regarded and paid.  Simple as that.  

Healthcare Reform is a complex issue that holds many facets which need change or modifications.  But an attitude of entitlement from both the patient that someone is going to take care of their body, and the Therapist of high pay for low skilled work both NEED TO CHANGE.

Therapists need to make certain that THEY are not being part of the Healthcare problem.

Marisa, Outpatient - Physical Therapist, Private Practice August 31, 2012 12:11 PM
Fort Myers FL

Dean- well written. Sometimes politicians come up with these grand ideas that seem great on paper, but how much competitive shopping is a 75-year-old going to do when ordering a meal off a menu or pressing buttons to advance into a voicemail system is difficult. And yes, I dont understand why I am paying for Medicare now as a 28-year-old when Medicare will almost certainly be gone for me to use it.  

Lots of tough things to consider. Going to be an interesting election, and it isn't that far away!

Lisa Mueller August 24, 2012 3:09 PM

Lisa, I had to study the ACA in detail for one of my public health courses last year. It is immense and tough to sort out the details even when one is a health professional. How can the general public make heads or tails of it, I wonder? I agree that it seems reasonable and forward thinking at first glance.

The voucher system concerns me. I think about my elderly patients, the ones who can't figure out email, get confused or anxious when an "official looking" letter arrives in the mail, and the ones with some degree of cognitive impairment. We're going to ask them to manage their own vouchers? It took me 2 years to explain what a medicare advantage plan was to my own mother!

Also, as someone rather near the 54 year old cut off age, I'm a wee bit annoyed that a system I've been paying into for over 30 years will may not be there for me in the future.

Do I have an answer? No.

However after working in the NHS for the past 3 years, I am full of ideas which I'm excited to bring back with me when I return to the states next month.

Kudos for starting this discussion!


Dean Metz August 24, 2012 11:59 AM

Shelby- thanks for sharing your thoughts. I agree, I think most people know a change is needed but the proposals of our politicians (voucher systems?) are confusing. I loved the learning about current healthcare issues in school, I hope you enjoyed it as well!  

Lisa Mueller August 23, 2012 9:34 PM

I'm currently an OT student and we just had a class dedicated to current healthcare issues.  I had not known much to begin with but I have realized how important it is.  The Affordable Care Act sounds peachy, but we will see how it turns out.  I think it is good that we are at least moving the direction of change as it is evident that it is needed.  The only thing we studied really about Mitt Romney is that he is in favor of a voucher system that I do not fully understand.  Either way this election is going to cause a big impact for healthcare.

Shelby August 23, 2012 9:26 PM

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