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Questions For Nashville
The Nashville, Tenn. downtown area and the Cumberland River are shown on Sept. 27, 2011. (AP)

The Nashville, Tenn. downtown area and the Cumberland River are shown on Sept. 27, 2011. (AP)

On Point is headed to Nashville on March 29 to tape the show before a live audience with public radio’s WPLN. We’re excited! The topic is implementing the Affordable Care Act – “Obamacare” – and we would love your questions to put to our Nashville panel…

Nashville is an vibrant medical center. What’s your question on how the Affordable Care Act is actually going to roll out this year? Are you a doctor? A hospital manager? Are you prepping now for Obamacare? What’s your question? On how it’s going to work? On its impact? Its reach? Its side-effects?

Are you a patient, wondering exactly how you will interact with the new system? What’s your question?

We welcome all questions, great and small. Post your questions right here, and we’ll use them to interrogate our terrific panel.

If you’re in Nashville, we hope we’ll see you there. And if you’re not, here’s your chance. Fire away! (And please include your name and where you’re from!)

Many thanks,

Tom

Please follow our community rules when engaging in comment discussion on this site.
  • http://www.facebook.com/jeffrey.palmer.16 Jeffrey Palmer

    From Jeff Palmer in Middletown, CT:

    It appears that patient care will be overseen my ACOs (Accountable Care Organizations) that will be responsible for outcomes and managing costs, usually on a capitation basis. Hospitals and large practice organizations will probably be the ACOs. My question is if you have medical insurance and your doctor is participating on the insurance panel BUT is not part of the ACO that you are part of, can you see your doctor or must you now ONLY be treated by member doctors of that ACO? Also, will we all be assigned to a particular ACO and how will that take place? 

  • Estevan Carlos Benson

    How easy or difficult will it be to remedy the nuanced problems of Obamacare?  That’s assuming we keep the fundamentals of the healthcare act in place.  How would you improve it while still keeping it in tact?

  • Matt Lamb

    Related to the Affordable Care Act is the movement toward electronic health records.  I work as a consultant in this field and am therefore somewhat biased, but I do believe the movement from paper records to electronic data that is accessible by multiple care providers has great potential to reduce redundancy, increase communication, and decrease costs (beyond the initial costs of implementation of an EHR).  Have the facilities in Nashville implemented an EHR and have they seen or do they foresee benefits from it’s use?

    • http://twitter.com/LilODarlin Judy Vaughan-Turner

       One of our clients has been taking an extended course in ehr and how it interacts with HIPPA.

  • EloiseAnderson

    Name = Eloise Anderson….I am a 55-year old female.  I work for a small business with wonderful owners, I earn a good income, but the company does not offer a health insurance benefit.  After my husband left six years ago, we’ve remained married solely so I could be covered on his health insurance through his employer.  I’m generally healthy, take care of myself, but have a couple of conditions which render me uninsurable.  He has filed for divorce now, which means I’ll have to pay high COBRA rates to have coverage.  I THINK I’M ONE OF THE PEOPLE THE LAW WAS PASSED TO PROTECT.  It’s my understanding that the changes mean I can’t be denied coverage, but how will the costs of this be covered so that my insurance is affordable?  Is there an income threshhold which could mean that I “earn too much” to qualify for the affordable coverage and therefore have to pay an unmanageable premium? On the one hand, I really want to feel relieved about the changes because COBRA rates are unaffordable and will only cover me for 18 months, but on the other, if the rates are going to be astronomical because they’re covering pre-existing conditions, I’m not sure I’m that much better off??

  • http://www.facebook.com/grace.s.smith Grace Sutherland Smith

    There are many things about the new healthcare law that I support, like providing coverage to so many who are uninsured and not allowing insurance companies to deny coverage for pre-existing conditions. However, I remain concerned about how we, as a country and taxpayers, are going to pay for it.  All I’ve heard so far is that it’s paid for by cost savings.  How can we afford this massive expansion of healthcare when we have such a huge federal debt?

  • http://twitter.com/BenPalos Ben Palos

    ·        
    How will the ACA impact the medical education system? For
    instance, the law has incentives to drive medical students to primary care.
    Will those incentives be effective? How will educational institutions need to
    change to meet the current and growing shortage of primary care physicians?

  • davidhorn222

    I believe that until cash for service with a catastrophe policy returns to the health care system in the U.S., nothing substantive will change. Health Systems, Physicians and Insurance Companies will set up their businesses to attract paying patients -whether with cash or, gov’t vouchers for Medicare and Medicaid, and there will be bare bones systems that don’t cost much all the way to systems where people need their feet massaged while they visit their Harvard trained Orthopedist. (No offense to Harvard or Orthopedists). Many of us would gladly buy and be able to pay for a system where it is okay to ask, “what will that cost?” Can you imagine Walmart running a medical practice for cash and if you get really sick, an insurance company-owned by Walmart-(or someone else-there will be plenty of them) offers you NO OUT OF POCKET COSTS UP TO SOME ACTUARIAL SOUND LIMIT if you go to one of 3 treatment facilities that they recommend. I CAN and I WILL SIGN UP TOMORROW. While most of our government and healthcare leaders believe patients first concern is endless choice in physician-treatment-etc., most patients only want the opportunity to pay for their affordable day to day services with the understanding that should something catastrophic occur, their family will not be bankrupted. Nurses, Nurse Practitioners, Pharmacy techs will win. Specialists will charge much less. Some physicians will go back to nursing school because that is where the jobs are, administrative costs will plummet, patients will be happier and we can watch with wonder as new ideas arise from the free market. What we have now is a sea of well-intended regulation that only prevents the above from happening. Thanks. davidhorn222@yahoo.com

  • herfman77

    I am a
    registered nurse, working in a very busy emergency room in Middle Tennessee. My
    hospital is not-for-profit, giving me an intimate familiarity with
    chronically-ill patients who, for social, psychological, and/or educational
    deficits, are non-compliant or poorly compliant with medical therapies.

    While I
    think most people understand that preventative care and early intervention in
    disease process saves money, there is also significant savings to be had on the
    chronic and acute end of the spectrum. Ten percent of Medicare patients
    represent nearly 70 percent of Medicare spending.

    In 2006,
    Massachusetts General Hospital began a three-year program to study the impact of
    intensive interventions to improve outcomes with this patient population. They
    used nurse coordinators along with case managers to closely follow these
    patients, using phone calls and home visits, checking medication compliance and
    assessing for any new problems or worsening old ones. They would go so far as
    to arrange transportation for doctor appointments.

    The
    outcome was that hospital readmissions dropped 20% and emergency room visits
    dropped 13%. Real money. While I’m certain that most of the people listening to
    this show resent deeply (as do I) the idea that we have to chase people down to
    give them the privilege of improved health, I am very ready to hold my nose and
    save the money.

    When are
    the opponents of Obama Care going to learn the hard economics of health
    care–that we all pay for everyone’s health care. The uninsured don’t just
    quietly die at home. They wait until the last minute to show up in the ER, get
    extended and hugely expensive medical interventions, and then do the whole
    thing again the following month. That money will always come from everyone who
    pays taxes or purchases health insurance. You and I.

    Does your
    panel have any ideas on helping to make the public more aware of this
    fundamental economic reality?

  • http://www.facebook.com/people/Rebekah-Becky-Majors-Manley/100000808133635 Rebekah Becky Majors-Manley

    HASLAM MADE THIS CHOICE — Haslam must answer for it 
     Gov. Haslam declined $12 billion that would have provided security for Tennessee’s working families, 
    rural hospitals, & small businesses
     Haslam’s decision neglects a broad coalition of people and businesses who were counting on him to 
    bring $12 billion of Tennessee taxpayer dollars back home to our state. 
     Haslam left $12 billion on the table, saying he has a better way — the “Tennessee Plan” — to insure our 
    working families, support our rural communities, and provide security for small businesses. We are 
    counting on him to put the TN Plan into action. 
     Haslam rejected $12 billion, and now it’s up to him to pass and implement his “Tennessee Plan.” He 
    must have the confidence he can make the TN Plan happen for us. 
     Haslam assumed a great responsibility when he rejected the funds on the table. 
    IMPACT OF THE CHOICE HASLAM MADE
     According to the Tennessee Hospital Association (THA), our state will lose 90,000 jobs because Haslam 
    chose to reject the funds 
     21 rural hospitals will close; their communities lose jobs (often their biggest employer) and health care; 
    those residents are forced to travel for basic health care and burden urban ER and facilities
     24 more rural hospitals take on risk of closing 
     180,000-300,000 working people (and their families) lose option of affordable health care
     Working people can still shop for health plans on the ACA marketplace; folks making 100-400% FPL are 
    eligible for tax subsidies (sliding scale) 
     According to Jackson-Hewitt, TN businesses will pay up to $89.3 million in tax penalties

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