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  • So why exactly have so many of our politicians addressed health care? One way of seeing the impact is looking at countries with similar levels of development. So, Let’s make some comparisons between other developed countries
  • Frontline, Sick Around the World is a link which describes in depth the development, a description of the differences and similarities and some of the concerns. However, All of these countries have a system of health care which provides for all its citizens. And they have existed for many years. They do vary in in how they are funded, governed and some of the concerns that have evolved. However, they have in common that health care is available to all and a primary player is the government.
  • I was encouraged to use the actual bill for my researchThe HCR is a very large document. One of my sources, the Kaiser Timeframe which summarizes the points was 21 pages long. So if we reviewed each clause, we could be here until next week. 2. So I have collapsed the individual reforms into 4 different categories. health insurance, including Impacts on Medicaid and Medicare; prevention and wellness, funding which impacts the bill, built-in protections, programs which encourage Research and improvements.
  • The coverage of medication cost is another factor in high cost to seniors, especially.Most of the medication changes occurred in 2010, with the Rebates of $250 were given in 2010 for those who reach Part D coverage gap and Medicaid Drug Rebate which increases the rebate percentage for use of certain drugs..  
  • Health insurance reform will close the coverage gap in Medicare Part D by 2020, so seniors do not have to worry about losing coverage for their drug costs. This will be phased in, but immediately there will be a 50% discount for certain medication, This is a graphic depiction of the Donut hole. This actually came from Wikipedia which my daughter says is a no no. The U.S. Department of Health and Human Services estimates that more than a quarter of Part D participants stop following their prescribed regimen of drugs when they hit the donut hole.[
  • Patient-Centered Outcomes Research: Funds comparative clinical effectiveness research which compares health outcomes and clinical effectiveness, risks, and benefits of 2 or more medical treatments or servicesState Healthcare Workforce Development: Grants for state partnerships to address healthcare workforce issuesHealthcare Workforce Assessment: Creates National Center for Healthcare Workforce AnalysisState/regional workforce analysis grantsNational Healthcare Workforce Commission: A resource to Congress; high priority is nursing workforce capacity
  • The major movement against health reform is the bill to Repealing the Job Killing Health Care Law Act which was passed in the house in Feb 2. The Senate of course defeated the bill and there is was no chance that President Obama would have signed any such bill. Currently there are about 22 major cases at the state level. One of the major is in Virginia where U.S. District Judge Hudson struck down part of the requirement to pay a fine if not insurance as an unjustified expansion of Congress’s authority. In addition there are a number of other cases in Virginia which have rulings that are pending the Circuit Courts and one that is possibly being punted directly to the Supreme Court.Other Cases in New Jersey, DC, Texas and Tennessee have already been dismissed.The major reason for these bills and law cases is to draw attention , assist states who have court cases and to place decisions on the bill in the Supreme Court. With the constituency of the current court, it will be difficult to predict how they will rule. It appears that many decisions are made along partisan lines.,
  • These are just a few of the obvious opponents.  Sara Paelin, I don’t think I need to ad anything about her oppositionBlue Dogs: Romney: actually has a Hc bill in Mass but saysThe federal government isn’t the answer for running healthcare any more than it’s the answer for running Amtrak or the Post Office. An economy run by the federal government doesn’t work for Europe and it won’t work here. Tea Party Members: While the debate over states’ rights is as old as the nation -- the issue was major factor in the Civil War -- the Tea Party’s disdain for the federal government has taken it to new heights, and new extremes. In Texas, Gov. Rick Perry has openly discussed secession as a viable option in the state’s ongoing battles over issues like environmental regulation and Medicaid funding.Opponents of health care reform also invoke states rights in arguing that the federal government has overstepped its bounds by requiring Americans to purchase health insurance as part of the reform planBoehner, who has pledged to do away with health care reformEric Cantor, Mr No. No to everythingMichael Grimm"What am I, not supposed to have health care?" he said. "It's practicality. I'm not going to become a burden for the state because I don't have health care, and God forbid I get into an accident and I can't afford the operation. That can happen to anyone.“Charles Grassley (R-Iowa) said it would empower the government to "pull the plug on grandma.“All types of pressure is being used to alter the HCR bill such as holding it hostage as a condition for raising the debt ceiling. As late as June 16, Rep. Steve King (R-Iowa) filed a discharge petition to force a vote on repeal of the healthcare reform law. If the petition gets enough support - it needs an absolute majority, or 218 votes - a bill to repeal the law would go to the House floor even if the majority leader objects.GOP requestedstudy by McKinsey & Co., as many as 30 percent of companies will stop offering health insurance to their employees when President Obama's healthcare reform law goes into effect in 2014. The White House dismissed the study as an outlier, and it has come under fire from the left in large part because McKinsey has refused to release its methodology.The House Energy and Commerce Committee held a hearing June 20 on the Medicare payment board that has become the top target in Republicans' attempt to dismantle the new healthcare reform law.The Independent Payments Advisory Board, or IPAB, will comprise healthcare experts and will target specific services for Medicare payment cuts. Its recommendations will take effect automatically unless Congress votes to block them — and comes up with the same amount of cuts elsewhere in the federal budget.Republicans charge that the IPAB is a "rationing board" — a panel of unelected officials with the power to make cuts that could lead to the denial of care. Democrats say it's one of the most promising cost-control mechanisms in the entire healthcare law..
  • Slideshare health care reform_3

    1. 1. HEALTH CARE REFORM<br />What Every Nurse Should Know<br />American<br />Martina Travis, BSRN, MPH<br />July13, 2011<br />
    2. 2.
    3. 3. OBJECTIVES<br />BY THE END OF THIS PRESENTATION, PARTICIPANTS WILL:<br /><ul><li>Know major components and proposed timeframes for the HCR Bill.
    4. 4. Know how the HCR Bill may impact nursing care and sh
    5. 5. Know the status of attempts to impede the implementation of the bill.</li></li></ul><li>EARLY HEALTH CARE REFORM<br /><br />
    7. 7. How Do We CompareTo Other Developed Nations<br />Japan<br />Taiwan<br />United Kingdom<br />Canada<br />Switzerland<br />Germany<br />Frontline, Sick Around the World<br />
    8. 8. COMPARISON TO OTHER COUNTRIES<br />Organization for Economic Co-operation and Development, 2007 report<br />
    9. 9. COMPARISON TO OTHER COUNTRIES<br />Organization for Economic Co-operation and Development, 2007 report<br />
    10. 10. COMPARISON TO OTHER COUNTRIES<br />Organization for Economic Co-operation and Development, 2007 report<br />
    11. 11. How Do We CompareTo Other Developed Nations<br />Japan<br />Taiwan<br />United Kingdom<br />Canada<br />Switzerland<br />Germany<br />Frontline, Sick Around the World<br />
    12. 12. APPROACH<br /><br />
    13. 13. Insurances<br /><ul><li>Requirement to have insurance 2014
    14. 14. Health Care Exchanges
    15. 15. Multi-State Plan
    16. 16. Health Care Choice Compact
    17. 17. Co-op Insurance </li></li></ul><li>Children<br /><ul><li>2010- Pre-existing Conditions
    18. 18. 2010-Young adults remain on parent’s plan
    19. 19. 2015-Extension of CHIP</li></li></ul><li>LONG TERM CARE<br />Long Term Care Service 2010<br />CLASS -2011<br />
    20. 20. MEDICAID and MEDICARECHANGES<br />
    21. 21. Drug Reform<br /><br />
    22. 22. DONUT HOLE<br />2009 Medicare Part D payments<br />
    23. 23. Prevention and Wellness<br /><br />
    24. 24. Monitoring HCRBuilt in protections<br />
    25. 25. Financing through tax and fines<br /><br />
    26. 26. Impact of health care modernization on the Federal Budget, 2010–2019<br />Center for American Progress | Financing Health Care Reform, 2009<br />
    27. 27. TAXES <br />Tanning Tax of 2010<br />Changes Tax Free Savings Accounts 2011<br />Pharmacy Co. Fee<br />Medicare Tax Increase 2013 <br />Medical Devices -2013<br />High cost (value) insurance employee provided insurance 2018<br />
    28. 28. Research<br />
    29. 29. HCR-IMPLICATIONS FOR NURSING<br /><ul><li>Competent, efficient care
    30. 30. Affordable
    31. 31. Allows for choice and accountability</li></ul><br />Copyright © National Academy of Sciences. All rights reserved.<br />The Future of Nursing: Leading Change, Advancing Health<br /><br />
    32. 32. Robert Wood JohnsonFuture of Nursing<br /><br />
    33. 33. INDICATORS OF NURSING SHORTAGE<br /><ul><li></li></li></ul><li>NURSING SHORTAGE<br />Aging nursing population<br />A shortage of nursing school faculty<br />
    34. 34. Aging population<br />Insufficient staffing<br />High nurse turnover and vacancy rate<br />
    35. 35. TRANSFORMING THE NURSING PROFESSION:<br /><ul><li>Practice extent of education / training.
    36. 36. Achieve higher education in better education system
    37. 37. Full partners, with doctors and other professionals, in HC redesign
    38. 38. Workforce planning / policy making require better data and information infrastructure.</li></li></ul><li>EDUCATION<br /><br />
    39. 39. CURRENT RESTRICTIONS<br /><br />
    40. 40. CLINICAL EXPANSION<br /><br />
    41. 41. RESEARCH/ASSESSMENTS<br />
    42. 42. COURT CASES<br />
    43. 43. In 2009, Sarah Paelin had the distinction of being awarded the “LIE OF THE YEAR” by Politifact — the Pulitzer-Prize winning project of the St. Petersburg Times . What was it?<br />
    44. 44.
    45. 45. Opposition<br />
    46. 46. RYAN BILL<br />55 year old and younger<br />Bears similarities to current proposal<br />
    47. 47. “<br />Stay committed to your decisions, but stay flexible in your approach.”<br /> Tom Robbins<br />
    48. 48.<br /><br />
    49. 49. REFERENCES<br /><br /><br />National Academies Press.ISBN: 0-309-15824-9, 620 pages, 6 x 9, (2010)<br /><br />The Future of Nursing: Leading Change, Advancing<br />Health, Committee on the Robert Wood Johnson Foundation<br />Copyright © National Academy of Sciences. All rights reserved.<br />The Future of Nursing: Leading Change, Advancing Health<br /><br />
    50. 50. REFERENCES<br /><br /><br /><br /><br />
    51. 51. REFERENCES<br /><br /><br /><br />From Medscape Medical News<br />Healthcare Reform Legislation Effects on Nursing: An Expert Interview With Rebecca M. Patton, MSN, RN, CNOR<br />Laurie Barclay, MD<br />
    52. 52. REFERENCES<br />Fact Check: Pat Boone On The Ryan Plan Marilyn WerberSerafini , KHN Staff Writer May 27, 2011<br />Healthcare Reform and Nurses: Challenges and Opportunities<br />Laura A. Stokowski, RN, MS<br /> <br /><br />