How Will The Presidential Election Affect Nurse Practitioners?

With the highly anticipated vice-presidential debate tonight (insert Biden joke here regardless of your political affiliation), I feel compelled to discuss how a win from either candidate will affect the nurse practitioner profession.  

Political discussions give me a migraine.  I certainly have my opinions about how our country should be run, especially since one of today's hot topics, healthcare, directly affects my profession.  However, I am generally one to shut my mouth in public and keep the peace.  I do believe that even though I tend to avoid heated political debate in order to prevent developing a massive headache, it is important to be informed.  So, let's look at the basics of each candidate's plan and it's implications for NP's.

The Romney-Ryan Health Plan

The headline beaming from the top of the health care page on Mitt Romney's website says it all 'Health Care: Repeal and Replace Obamacare'.  Romney promises to issue an executive order on his first day in office repealing the Affordable Care Act in it's entirety.  Although he hopes to change the course of Obamacare, Romney does agree that the U.S. health care system could use a make-over.  Romney pledges to bestow more power upon individual states to "craft the approaches best suited to their own citizens".  

On a federal level, Romney hopes to ensure that Americans currently uninsured find assistance.  He will enact public-private partnerships and exchanges to help the uninsured as well as offer access to high-risk insurance pools and risk adjusted plans for the chronically ill.  Like Obama's health plan, Romney's plan intends to prevent discrimination against individuals with pre-existing conditions allowing them the opportunity to become insured. 

Romney's health care plan is based on the fundamentals of free market, fair competition and consumer choice.  He promotes legislation to cap economic damages from malpractice lawsuits and empower individuals and small businesses in their abilities to purchase tax-effective health insurance plans.  Overall, Romney's plan focuses on empowering the states and individuals while offering a few tweaks to the pre-Obamacare health system at the federal level.

The Obama-Biden Health Plan

We have all had exposure to Obama's plans for health care in the U.S.  If reelected, Obama will continue to roll-out the phases of the Affordable Care Act as planned until 2014, the projected year of complete implementation.  The Affordable Care Act promises an overwhelmingly federally regulated health care system.  Under this plan, individuals are mandated to purchase health insurance or face a monetary penalty ($695 or 2.5% of total income, whichever is greater).  Government programs such as Medicaid will be expanded under Obama to offer health care coverage to a larger number of Americans.  In relation to Medicare, the Affordable Care Act promises to reduce costs of prescription medications as well as increase coverage of preventative services for older Americans. It is projected that the Affordable Care Act will extend coverage to about 33 million uninsured Americans. 

The Romney-Ryan Plan's Implications for Nurse Practitioners

Romney's plan lends stability to the nurse practitioner profession.  With states and individuals allowed control of their health plans, it is likely that with a Romney win, your state will get a health plan that is tailored to your specific region.  In my experience, when a touchy issue like health care is solved on a more individualized basis, patients are typically happier with their situations and this attitude is extended to their clinic experience.  Romney's promise to assist individuals with preexisting conditions in receiving health coverage also promises to increase the patient population.  More patients leads to more jobs and higher incomes for nurse practitioners.  

Romney's plans call on the capitalist system to create value, demand and fair pricing for health care services.  With less government control, as a nurse practitioner these economic principles will lead to less legislation controlling your practice giving you more independence.  Always a positive, independence leads to less paperwork and reduces the daily hassles of dealing with the government organizations Medicare and Medicaid.

The drawback of Romney's plan for NP's?  It is difficult to evaluate Romney's health plan as thoroughly as Obama's as it is not yet written into the letter of the law.  We don't yet know all of the specifics. 

The Obama-Biden Plan's Implications for Nurse Practitioners

The 33 million Americans promised health insurance coverage through the Affordable Care Act is certainly a positive for nurse practitioners.  More patients leads to an increase in the number of job opportunities for NP's.  Higher demand for health care services will also increase nurse practitioner salaries.

Does the Obama health plan pose any negatives for NP's?  The Affordable Care Act proposes federal legislation on a large scale and an increase in government involvement in the daily activities associated with providing health care services.  This means more paperwork, more restrictions regulating your practice and a higher number of insurance issues such as prescription preauthorizations.  Whenever the government becomes more involved in an industy, the amount of red tape one must endure on a daily basis increases.  In my experinece, legislation and paperwork are a drain on your patients and your practice. 

Conclusions

Both candidates offer to increase demand for health care services and therefore demand for nurse practitioners by offering health insurance to those not currently covered.  Obama's plan offers insurance on a larger scale than Romney's likely lending healthcare coverage to a larger number of Americans.

Depending on which candidate wins, you daily NP life is likely to be affected.  Obama's Affordable Care Act is federally regulated and highly legislative which can create headaches in the daily management of your clinic or hospital system. Romney's plan does not propose such massive change to the health care system and calls for more localized and individualized health care reform preventing some of these issues.

What do you think?

We aren't here to tell each other how to vote but to help one another cast an informed ballot this election season.  Share your opinions by commenting below!