Gauging Obamacare

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Elon community’s perspective on the Health Care Reform Act

About this website

In light of the recent election, this report analyzes the extent to which healthcare affects the Elon community. Throughout this site, there are articles pertaining to medical school, religious affiliation and the influence on voting preference. The timeline above provides context concerning the healthcare act and how it moved through Congress.

The members who contributed to this team multimedia journalism report include Melissa Kansky, Natalie Dupuis, Sam Parker, Lindsay Kimble, Gabriela Szewcow and Derek Wickham.

Examining the Healthcare Reform Act

Summarizing the Healthcare Reform Act

The campaign season escalated debates concerning the Healthcare Reform Act.

“I don’t know that there’s a perfect answer that’s going to satisfy everyone, but I think you have to err on the side of giving the most opportunity and freedom to everyone.” – Lauren Emery, interim assistant chaplain


Healthcare reform incites greater need for medical professionals

By Melissa Kansky

Increased access equals a greater number of patients. The current healthcare climate, coupled with the Healthcare Reform Act, produced an environment hungry for more medical care providers, according to Mark Archambault, department chair, program director and associate professor of physician assistant studies at Elon University.

The Association of American Medical Colleges estimates in 2015 the country will have 62,900 fewer doctors in comparison to the number of citizens who will have access to healthcare. The need provokes a modification at the education level.

Elon’s physician assistant master’s program will enroll its first class January 2013.

“The university had already started the process and determined a program was needed and feasible,” Archambault said. “The Healthcare Act just reinforced that assessment and provided further validation.”

A growing need

The newly established program contributes to the expansion of programs throughout the country. Since 2007, the number of physician assistant programs has exhibited a trajectory of growth, according to the Accreditation Review Commission on Education for the Physician Assistant, Inc.

Nationally, physical therapy programs are experiencing a similar trend. Physical therapy is the second department housed in Elon’s School of Health Sciences.

“There’s a trade off of slowly expanding existing programs or adding new programs,” said Stephen Folger, professor of physical therapy education.

The growing number of programs translates to more physical therapists each year effectively serving the increasing number of patients.

Archambault said he recognizes the necessity for greater accessibility, which in turn creates a demand for more trained doctors.

The physician assistant programs’ success is directly related to the passage of the Healthcare Reform Act, Archambault said.

The number of applicants increased 19.6 percent from 2009 to 2010, and the number of matriculates increased 14.2 percent. But while the number of applicants continued to climb from 2010 to 2011, however that of matriculates exhibited a decrease of 4 percent.

“Healthcare is in a state where things need to change, and the goal of finding other providers who can efficiently and effectively open access to care is needed,” Archambault said.

While the faculty in the physician therapy program, the second department in Elon’s School of Health Sciences, questions the program’s relationship to the Healthcare Reform Act, Folger predicts a change.

“I think that really it’s certainly going to have an important impact on the profession but to predict the extent is difficult,” Folger said.

Defining the services available

The definition of “essential service” is unclear but determines the degree to which insurance reimbursement will change, he said. Currently, physical therapy is not considered an essential service, which has the potential to impact the physician’s salary.

“If we don’t become one of these essential groups, there could be a reduction in physical therapy student applicants,” Folger said.

Nevertheless, Folger agrees increased access to health insurance generates more physical therapy patients, producing a need for more physical therapists or effectively reducing the amount of time physicians can devote to their respective patients.

While he said he hopes the Healthcare Reform Act will positively impact the medical profession, “it puts a strain on a system that is already at its limit in some areas.”

In courses, students are required to enroll in a course titled Today’s Healthcare System, in which they are taught to evaluate the patient’s insurance and devise an appropriate plan. Insurance plans that set limits on the number of physical therapy visits determine what treatment the physician can offer while still achieving the highest impact.

Furthermore, students work for 48 weeks in the clinic with a mentor and develop a treatment that accommodates the injury as well as the insurance plan.

“In preparing our students for that environment, you have to prepare someone who has more experience coming out and can work in that environment where they can make more careful decisions with the patients,” Folger said.

Exhibiting stress in the field

Although Folger advocated for increased professional experience, Archambault identified clinical education experiences as the biggest challenge in the physician assistant curriculum.

“Our over-taxed healthcare system needs to be involved in the training of physician assistants, and the resources are stressed because of the demands put on the healthcare providers,” he said.

The current conditions make it difficult for providers to accommodate pre-accepting physician assistant students nationally, he explained.

Nevertheless, Archambault argues the physician assistant model of care addresses those concerns in the healthcare system. Physician assistants partner with a physician and develop a team of providers that care for multiple patients.

Elon’s program focuses on training primary care providers in the physician assistant program, according to Diane Duffy, director of clinical education.

“The highly functioning team allows each member of that team to function at their role at a high level, so they can expand their value and the services they are able to provide to patients,” she said.

The current climate can also attract more students to the physician assistant profession, according to Duffy. Students can complete the program in 27 months, compared to the seven years spent in school training to be a doctor.

“PA students are able to get out and start working sooner and from a financial standpoint, that makes sense for people,” she said.

Additionally, physician assistants enter the field and can fill the need more quickly, she explained.

Questions Remain

When training health science students, professors try to prepare students for the future and predict what is going to happen. But, the Healthcare Reform Act’s impact on the profession is still unclear, according to Folger.

If the Healthcare Reform Act provides coverage for preventative medicine, physical therapists can increase their role, but the insurance system is designed to reimburse providers after an injury, disease or diagnosis, Folger said.

He acknowledges the Act is a large milestone with regards to redeveloping the healthcare climate but said he has yet to witness any changes.

“We’re going to respond as things happen,” he said.

Religious individuals interpret the Healthcare Reform Act as means to assert dominance in society

By Sam Parker

President Barack Obama and his administration announced January 2012 the Affordable Healthcare Reform Act would mandate most health insurance plans cover a full range of contraceptives for women free of charge.

Included in this range of contraceptives are birth control pills, Plan B, ella and sterilization procedures.

The mandate does not apply to churches or institutions that primarily employ members of faith, but it does apply to all other businesses, including Catholic-affiliated nonprofit corporations, such as hospitals, charities and universities.

The inclusion of religiously-affiliated organizations led to political division between Obama’s administration and religious groups, specifically conservative Christian and Catholic organizations. Because Catholics historically do not support the use of contraceptives, the Roman Catholic Church asked for a broad exemption for Catholic-affiliated corporations. However, President Obama’s administration denied this request and instead granted religiously-affiliated organizations a one-year extension to implement the policy, giving them until Aug. 1, 2013 to comply.

But, in February 2012, the Obama administration loosened its grip, claiming church-affiliated hospitals, charities and universities would not have to adhere to the rule. Those organizations would not need to provide or pay for contraceptive coverage.

Despite this accommodating ruling, individuals across the country still expressed distaste regarding the Affordable Healthcare Reform Act. According to a Pew Research Center poll conducted in June 2012, 44 percent of respondents said they would be happy if the Supreme Court threw out the entire law, while 39 percent said they would be happy if the Supreme Court upheld the entire law. Disputes between different religious communities have emerged, as individuals of various faiths interpret the Affordable Healthcare Reform Act.

Christians

Some religious figures have argued the Affordable Healthcare Reform Act is a Christian issue primarily, specifically in terms of the contraceptive mandate, as disputes among Catholics and conservative Christians and the government continue.

Lauren Emery, interim assistant chaplain, said she thinks the Affordable Healthcare Reform Act applies to all Americans though, as 48.6 million Americans were uninsured in 2011, according to census.gov. Emery said healthcare affects more people than the uninsured; it is an issue that applies to the youth, the elderly, widows, orphans, the disabled, those with preexisting conditions and those who can afford coverage.

“It’s hard because I saw (families struggling) every day, but people are very removed from it, so it’s easy to be like, ‘Well I’ve got insurance. It’s handled for me.’–to not think about the enormous wealth of people that don’t have that or that do have a problem getting health insurance,” Emery said.

Individuals have argued the Healthcare Reform Act infringes on individuals’ religious freedoms, but Emery said she does not believe this is the case. She said it is an important economic issue Americans must consider.

“I think it’s a very practical imperative for the government to do so that we’re not taxing our resources way down the line when we could be providing preventative care and things earlier on,” Emery said.

In relation to Christian ideals, Emery said the Healthcare Reform Act applies to the Christian tradition to help the less fortunate.

“I believe that there should be some sort of at least minimal safeguard someplace to take care of those who are most vulnerable who can’t take care of themselves,” Emery said.

“As a Christian, I think it’s a Biblical mandate that we care for the least of these—for those individuals who can’t afford it, for the elderly, for widows, for orphans, for the disabled, for those with preexisting conditions and everything else. It’s absolutely imperative that we care for everyone.”

Emery said she realizes not all Americans agree though, and she said she is not sure it is possible for the government to reach a consensus that will please everyone.

“I don’t know that there’s a perfect answer that’s going to satisfy everyone, but I think you have to err on the side of giving the most opportunity and freedom to everyone,” Emery said. “Nobody’s going to force anyone to use the pill or anything like that, so I think that now, we’re making good strides towards getting some answers on these questions.”

Jews

Unlike Catholics and conservative Christians, the majority of American Jews approve the Act. In the 2012 Survey of American Jewish Opinion conducted by the American Jewish Committee, approximately 37 percent of respondents approved strongly of the way President Obama was handling healthcare.

Ginny Vellani, Hillel development and Jewish life associate, echoed the sentiments of the poll. She said American Judaism tends to be more liberal, and Jews tend to favor more expansive healthcare coverage.

Because Judaism has been a minority religion for the majority of its existence, Jews typically believe it is unreasonable to try to persuade an entire country to conform to one religion’s religious beliefs, according to Vellani.

“It’s sort of ridiculous to the Jewish mind that you would want society to conform to your religious values—that’s antithetical to what Jews expect or believe,” she said. “Society should not be conforming to a religion’s norms and expectations, and by being an active participant in the United States and receiving benefits like tax breaks and things like that, I think that religious organizations, from the Jewish perspective, are beholden to the country for the advantages that they’re getting there, including religious liberty.”

However, in addition to a religious issue, she interprets the healthcare conflict as an attempt to reassert male dominance.

The backlash to the Affordable Healthcare Reform Act is a last attempt by religious groups to maintain the traditional, patriarchal organization of religion, Vellani said.

“The more independence women have in terms of controlling their reproductive and sexual health, the more independence they have from the family and the traditional household structure and of their own lives,” Vellani said. “And I think this is sort of a last gasp to sort of be able to control that.”

Healthcare 2nd most important issue in 2012 election

By Lindsay Kimble

The campaigns leading up to the November 2012 elections placed much emphasis on the fate of healthcare in the United States. President Barack Obama’s reelection helped to solidify the future of the healthcare system as detailed in the Affordable Care Act, which is better known as Obamacare. The law is likely to be implemented in its entirety by January 2014.

The debate concerning Obamacare, which the Supreme Court upheld in June, will likely continue as the Obama administration works to implement its new provisions. Many voters cited healthcare as a top issue when deciding for whom to vote.

In an online survey of 100 respondents, 96 percent said they voted in the 2012 elections. Of the 96 percent that voted, 66 percent named healthcare the second most important issue that affected their vote, after the economy.

Of the 100 respondents, 58 percent said they know “only basic information” about the Affordable Care Act, while 32 percent said they were “very familiar” with the Act, and 10 percent said they know “nothing” about the act. A tie of 21 percent of voters said the Affordable Care Act either had “little impact” or a “huge impact” on their vote, while 51.5 percent of respondents said it “had an impact” on their vote.

The Elon community’s opinions closely align with the findings of a national poll conducted by the Kaiser Family Foundation immediately following the election. When asked to identify the top two factors influencing their voting decisions, without provided choices, healthcare came in third for both Obama and Romney voters.

With Obamacare’s implementation, the nonpartisan Congressional Budget Office projects more than 30 million uninsured Americans will gain health coverage. The estimated cost of healthcare reform over the next 10 years is $940 billion. Nevertheless, the bill is expected to reduce the deficit by $143 billion over the next 10 years.

Other key aspects of the law oblige insurers to provide coverage for non-dependent children until age 26 and call for the eventual elimination of the doughnut hole in Medicare by 2020.

 

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