So has Obamacare worked? Has it not? Is it helping or hurting?

[Hayabusa Rider]

It's not a Cadillac Plan

Then you should be (probably) ok. I wondered when you said "Union" because a lot of members found out they "drove" Cadillacs and are going to be pretty screwed, paying more and getting less.

 

[Hayabusa Rider]

Too bad that if we tried implementing the exact same system, a certain batch of people would attack it because it goes against the interests of health insurance companies (it would be blasted as "socialism").

This isn't Switzerland in any way. There's not even the intelligence necessary to figure what else is needed much less a whole system. You want a Swiss watch. You'll get something that makes the sequester seem like the greatest human accomplishment by comparison. Better luck getting Congress to build a FTL spaceship.

 

[Darwin333]

Have you talked to very many doctors about EMRs?

The doctors I spoke to hate it. The doctors spend more time entering into the EMR system then caring for patients.

Clinics and hospitals do not want to hire someone full time to enter information for the doctor, so the doctor is left to enter their own information.

The more time the doctor spends entering information into EMRs, the less time they have to see pts.

And its debatable if EMRs even improve care.

My doc had the same bitch, although I didn't realize it was because of the ACA, and I have noticed that he and the nurse that sees me beforehand spend a LOT more time entering info into the computer. I always thought it was patently retarded, it can't be that damn hard to digitize medical charts in a timely manner. Hell OCR has come a long damn way lately, it should be relatively easy to let Dr's do it the old way, if they so prefer, and then run it through a scanner at the end of the day.

I am guessing the problem is that they want the exact same info across the board so they are requiring them to go seriously overkill on the amount of info they input. Even the dumbass questions the nurses are forced to ask (not sure if its the hospital, ACA or other law) are a complete waste of time and geared mostly to the very elderly.

If that is the case there is a such thing as information overload. I don't want an ER doc to have to go through pages and pages of worthless information that isn't relevant to any condition I have or have had wasting time while my ass is laying on the table. Even if that doesn't happen, my personal doctor has definitely become less efficient since they implemented the new software and as long as I have gone there they have ALWAYS kept purely digital records so it is definitely the new software.

 

[Darwin333]

I've personally known people that have died because of a lack of EMR. EMR is really a necessity in this day and age.

Intelligent EMR, I would agree, is a necessity in this day and age. There is absolutely no need for a "one size fits all" system that spans a metric shitload of very different specialties. The "format" the data is in is less relevant than the actual relevant data.

OTOH, in order for EMR to be useful in life saving situations such as the ER there needs to be very easy access to it which brings up a huge privacy concern. If any ER doc in the country can access your medical records then anyone, and I mean ANYONE, who wants your medical records bad enough can access him.

 

[Darwin333]

The reason many doctors seem to hate it, especially the older ones, is because of the new technology they have to use. Many of them don't even know how to type. They will learn it and leverage it more efficiently as time goes on.

It's really similar to how computers were introduced to the workplace and forcing every employee to learn how to use word/excel, etc rather than using paper and pen for everything.

I have had the same doctor for over a decade and he has never kept a paper chart. He always used a workstation in the examination room to enter all of my info. Since the implementation of the new software, and from the parts I see its software only as the workstation didn't get changed, he has spent at least 3 times as long typing on the workstation. Luckily he can multitask on some of the routine things like making sure my scripts are up to date but often I have to stop in the middle of telling him something important to let him catch up on the computer or repeat myself once he is done.

It has NOT made him, again a doctor who has used a PC the entire time I have seen him, more efficient. It has had a profoundly opposite effect. Its not the computer, its the software. I don't know how the ACA mandates the implementation of the EMR's but I do know that this particular hospital/doctors offices software has been about as intelligent as a screen door on a submarine.

 

[Darwin333]

Too bad that if we tried implementing the exact same system, a certain batch of people would attack it because it goes against the interests of health insurance companies (it would be blasted as "socialism").

And the part that you don't recognize is that products will not be made if they can not be profitable. For every country that "regulates drug prices" (some even threaten to violate patents and procure illegally manufactured copies) that someone elses cost goes up in order to cover the loss. That someone else is usually us.... It is obviously not THE problem with our healthcare costs but the United States most definitely IS subsidizing medical costs for a shitton of other countries around the world. We are just doing it indirectly. Like I said, there are a bunch of issues and this is just one of them but imo its a pretty costly one for consumers.

 

[zinfamous]

The reason many doctors seem to hate it, especially the older ones, is because of the new technology they have to use. Many of them don't even know how to type. They will learn it and leverage it more efficiently as time goes on.

It's really similar to how computers were introduced to the workplace and forcing every employee to learn how to use word/excel, etc rather than using paper and pen for everything.

this is all, really.

times change. If they hate it now, they would hate it even more when they would be updating in the future anyway.

The reality is that these systems should have been updated more than a decade ago.

Paper is expensive. There is no reason for the medical industry to be so crippled as it is on the dependence of shuffling paper from office to office, and hospital to hospital.

 

[First]

http://blogs.marketwatch.com/health...-fed-researchers-say/?mod=MW_home_latest_news

Obamacare not to blame for jump in part-time jobs, Fed researchers say

If you think Obamacare is to blame for recent increases in part-time employment, the Federal Reserve of San Francisco says think again.

The bank issued a paper Monday saying that President Obama’s health-care overhaul probably has only a “small” role in the increase in part-time jobs as opposed to full-time employment. Authored by S.F. Fed research advisor Rob Valletta and research associate Leila Bengali, the paper focuses on reasons for the increase in part-time work but notes the law officially known as the Affordable Care Act probably has little to do with them.

“Before the law was passed, most large employers already faced [Internal Revenue Service ] rules that prevented them from denying available health benefits to full-time workers. These rules gave employers an incentive to create part-time jobs to avoid rising health benefit costs,” the paper says.

It goes on to say: “Moreover, recent research suggests that the ultimate increase in the incidence of part-time work when the ACA provisions are fully implemented is likely to be small, on the order of a 1 to 2 percentage point increase or less. This is consistent with the example of Hawaii, where part-time work increased only slightly in the two decades following enforcement of the state’s employer health-care mandate.”

The findings regarding Obamacare were a small portion of the the S.F. Fed’s overall study, which concluded that recent increases in part-time employment were similar to patterns that followed past recessions. The share of part-time jobs has risen from 17% in 2007 to nearly 20% in 2009 and remained there.

Valletta and Bengali note that adjusted figures show part-time employment after the 1982 recession comprised a slightly larger proportion of the overall jobs market.

“In particular, on a consistent basis, the part-time employment share peaked at 20.3% in 1983, slightly above the recent peak of 19.7% in 2010,” they wrote. “By this standard, the level of part-time work in recent years is not unprecedented, although its persistence during the ongoing recovery is unusual.”

Follow Russ Britt on Twitter @russbrittmktw

Follow Health Exchange on Twitter @MWHealthBlog

Conservatives still herp-a-derping about the negative effects of the ACA. They'll be singing about it til their political party's grave when they're forced to pay fealty to it the way they currently do with Medicare and Social Security.

 

[drebo]

Sounds like a "Cadillac" plan. If that's true then you are going to get screwed, but that's the purpose of the plan and a good thing, or so I'm told. If it's not then no one knows.

I'm fairly worried about Cadillac plans myself. My wife's insurance is very good (and also very expensive for us) but it covers quite a lot and only has a modest copay for all services.

She doesn't have any other plans available to her through her employer.

I'm afraid we're going to get fucked.

 

[sactoking]

It's not a Cadillac Plan

You cant be sure of that. Do you even know the definition of a Cadillac plan under the ACA? not meaning to pick on you but it's my experience that many people don't know the true legal provisions of that law. In fact nobody can say today what is our is not a Cadillac plan since that definition is tired to the rate of premium inflation in the GEHA program between now and 2018.

 

[Hayabusa Rider]

I'm fairly worried about Cadillac plans myself. My wife's insurance is very good (and also very expensive for us) but it covers quite a lot and only has a modest copay for all services.

She doesn't have any other plans available to her through her employer.

I'm afraid we're going to get fucked.

NPR several years ago ran a story about those who had really high premiums because they had someone in the family with long term expensive illnesses and it was most affordable to pay for better coverage. The short of it is that they were screwed by this. I hope that's not you.

 

[Zaap]

This isn't Switzerland in any way.

Yeah no kidding. Every time people use these sort of top-tier European nations as their so-called blueprint for this country, my thought is: "Pfft! Get back to us when our national average is the same for education, intelligence and drive as the Swiss national average."

 

[werepossum]

I'm fairly worried about Cadillac plans myself. My wife's insurance is very good (and also very expensive for us) but it covers quite a lot and only has a modest copay for all services.

She doesn't have any other plans available to her through her employer.

I'm afraid we're going to get fucked.

Obama promised that if you liked your insurance plan you could keep it, so, yeah, you're fucked. LOL

 

[mshan]

Anyone know if EMR now is like cell phones before Steve Jobs introduced the iPhone?

e. g. Are we talking Microsoft type mediocrity by corporate committee software?




edit: I brought up the Swiss model for health care reform because that is what I remember as being template for Obama's reform plan (in lieu of completely politically unfeasible single payer, Medicare for All), before it was bastardized by Congressional sausage making.

 

[Hayabusa Rider]

Anyone know if EMR now is like cell phones before Steve Jobs introduced the iPhone?

e. g. Are we talking Microsoft type mediocrity by corporate committee software?




edit: I brought up the Swiss model for health care reform because that is what I remember as being template for Obama's reform plan (in lieu of completely politically unfeasible single payer, Medicare for All), before it was bastardized by Congressional sausage making.

First part-
It's getting better but there is still problems with systems and users. Taking a practice and moving to electronic records is a herculean task and errors get introduced. Ever see prescription with two conflicting sets of directions? I do all the time. In fact e prescribing has increased certain errors. PIA.

Second, I don't think you understand the complexities of the issues. This isn't rocket science. No, it's much more complicated. What do we do? Get a bunch of people who don't know what they don't know, write thousands of pages of stuff without a clue on how things feed back on other things. Clueless.

We really need real health care reform but when something that needs experts to spend man-years on is done in short order politicians it's not going to be what it needs to be. But neither party gets that. They want to score points.

 

[IGBT]

it's wonderful..lots of part time jobs with no benefits out there!!

 

[Brian Stirling]

I used to be all for the computerization of medical records but at the time I didn't realize the obvious, after the NSA's bullshit I have zero faith in my medical records remaining private.

So you think the medical records your insurance company has on you are safe from the prying eyes of the NSA?

Or your banking records?

Or your credit card activity?

Or absolutely everything else?


Brian

 

[shira]

What kind of crappy insurance costs $80 a Month? That must have like a $7,000 deductable that you have to pay if you get sick. What is the point of insurance that does not pay for anything?

Why are you having such a difficult time understanding? HE pays about $80 a month. But his company probably pays $320 a month, for a total of almost $5000 a year in premiums. That's a fairly typical premium for a decent group policy.

 

[Incorruptible]

it's wonderful..lots of part time jobs with no benefits out there!!

People can thank obama for this. Him and his idiotic supporters said he would create jobs and many part time jobs were created.

 

[charrison]

My prior place of employment(small business) premiums went from $500 to $750/month for a high deductible family plan. It is not helping the little guys that is for sure.

On a side note, the high deductible plan before the premium increase was a more cost effective plan than my current plan. The high deductible plan was $11k worst case annual cost. My new plan has a total cost of 13k plus copays and out of pocket cost. Granted the new plan is better for me because it is heavily subsidized, it overall costs quite a bit more.

 

[PrinceofWands]

Regardless of how it impacts our health care it's a dismal failure in that utterly destroyed the last vestiges of freedom by mandating participation in private enterprise.

Since I refuse to take part in the insurance industry, the law will be of ZERO benefit to me. In fact, it will eventually put me in prison for life, or on the streets to die, since I will neither obtain insurance nor pay the fine. Providing my coming lawsuit fails of course.

 

[Zorkorist]

I'm with Prince of Wands.

I do not accept Government control of my health care.

I will not pay them a dime.

-John

 

[Zorkorist]

Government and Health Care = People thinking how to abort 16 year olds.

-John

 

[Zorkorist]

Government and Health Care = 17 Trillion dollars in debt.

-John

 

[Zorkorist]

Government, and Health Care, are not working.

-John