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I have been a registered nurse, nurse practitioner and most importantly a patient advocate for over 20 years. I have worked in hospitals, homes and as a private consultant, always teaching patients how to speak up for themselves and to make well informed healthcare decisions that are right for them and help them to avoid all types of Medical Errors. The many things I have seen in healthcare led me write "What Did the Doctor Just Say." In it are all the steps every patient needs to take to remain safe in the healthcare system and avoid medical errors. My personal goal is help to save 100,000 people from the horrors of a medical error and I wrote What Did the Doctor Just Say? to help make that happen.

Monday, March 22, 2010

What Healthcare Reform Means To You and to Us

President Obama will sign into law a healthcare reform bill that will provide  insurance to the 32 million Americans who are currently without it and the more than 2,000-page health insurance bill has left more than a few people wondering what the healthcare reform bill will mean to them.
Before we answer some of the most frequently asked questions about healthcare reform and this bill will affect you  I have a comment and a concern.
My comment; I think everyone should have access to healthcare and that having access is a matter of national security. Any nation can only be as healthy as it's people, if the people are sick they cannot work or contribute to the growth of the society.  And I think it is humane to give our citizens healthcare. 
Just today I met a 38 year old woman with breast cancer who was told if she could not explain how she was going to pay for her care that she should find a way to deal with the pain and plan to die within the year. She told me this as her daughter stood beside her holding her hand. In my mind there is something wrong with a doctor having to tell a patient to go home and die when there is treatment available because her employer does not have a benefit plan.  
However I am concerned that adding another 32 million people into our current healthcare system without adding additional nurses, doctors or hospitals will create more medical errors. The equation is this; 32 million more patients + nursing shortage + 30 percent doctor shortage + hospital closures = less time and space to see and treat each patient = more mistakes.  
If my equation is right and my 25 years in the system tells me I am, this new bill, while well intentioned will make protecting your health and safety when seeing a doctor or visiting a hospital an issue of personal security and could help to save your life.  
With the current volume of patients 40 percent of medical diagnosis are wrong and 1 in 3 prescriptions has some type of error contained in it's writing.  Can you imagine what the statistics will be with an additional 32 million people. 
In order to protect you and your loved ones from the horrors of a medical error I think every patient entering the healthcare system should have a copy of What Did the Doctor Just Say? so that they can learn how to protect themselves and their loved ones from the horrors of a medical error and I truly believe this is a matter of the utmost importance. Having made my comment and voiced my concern, let's move onto the questions everyone else is asking about the healthcare reform bill and that is how will it affect me?   
I don't have health insurance, what does this mean for me?
By 2014, every American will be required to have some form of health insurance or will be forced to pay a fine. The first year's fine would be $95 or 1 percent of their income, whichever is higher. By the second year, however, fines could rise to as much as $695 a year. Families and people meeting certain income requirements ($14,404 for individuals and $29,326 for a family of four) would be exempt from paying the fine. These people may also be eligible for the federally and state-funded Medicaid insurance program that covers poor and disabled Americans under the age of 65. 

One of the immediate changes that will take place is that young adults up to the age of 26 will be eligible to remain on their families' health insurance plans. Currently, the cut-off is 22 years old. 

Can I buy insurance through the government?
The bill does not include a public option, meaning the government will not offer health care beyond Medicare and Medicaid. People under the age of 65 who make too much to qualify for Medicaid may be eligible to receive government subsidies to help them buy private health care from new state-based insurance "exchanges," which are scheduled to begin in 2014.

My employer does not currently offer insurance, will that change?
All employers will be required to offer their employees insurance by 2014. Companies with 25 or fewer employees would receive tax credits to help them pay for the insurance. The tax credits would cover about 35 percent of the insurance cost this year and would gradually increase to about 50 percent by 2014. Employers with 50 or more workers will be required to offer employees insurance or pay a fine of up to $2,000 a piece for full-time employees that are receiving government subsidies to buy insurance through state-based exchanges. The first 30 employees would be exempt from this fine. 

How will this legislation affect senior citizens receiving Medicare?
Starting this year, all Medicare preventative services, such as cancer screenings, will be offered free of charge to senior citizens currently receiving Medicare. Also, people receiving Medicare Part D would receive an additional $250 this year to help them pay for medications that are not currently covered under the plan. 

I have insurance, how will this affect me?
Under the plan, people who are currently ill may begin seeing their premiums shrink, as the bill does not allow insurers to charge higher premiums to people who are sick. Also, people with pre-existing conditions who change insurance companies, due to a change in job status or in employer coverage, cannot be denied coverage under the bill, nor can they be charged higher premiums.

How much will this cost and how is it being paid for?
The plan will cost an estimated $940 million. Congress and the president have said that most of it will be paid for through various tax increases on individuals that earn more than $250,000 a year, as well through decreases in Medicare reimbursements to doctors and hospitals. Critics, however, say tax increases to the wealthy and Medicare cuts will not be enough to fund health reform and that the middle class will eventually be forced to help pay for it through tax and fee increases.

Questions Written By Marrecca Fiore Mar 22nd 2010 9:57AM
Comments and Concerns by Lynn R. Parker

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