Defining the future of health care
The Jacobs Medical Center is more than just a building. At the hub of the world #39;s most vibrant biomedical communities, a vision is becoming reality. Through ...

By: UC San Diego Health System

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Defining the future of health care - Video

One thing's for sure when it comes to the impact of the Affordable Care Act: Health care and related industries are going to be on a hiring spree in the years to come to meet the demands of the law.

While critics say the law will cause companies to cut jobs or work hours so they will not be penalized for not offering health care coverage actions that are already under way, according to anecdotal reports other observers say the law will create scores of jobs.

Health care providers will need more nurse practitioners and physician assistants, and companies that are required to offer insurance to employees will need more human resources staffers to keep track of their compliance. Experts also expect more jobs for computer programmers and other information technology professionals, customer service representatives, insurance agents, and wellness and fitness coaches.

Susan Mesa, president of the job placement service AdvancedPractice.com, said the Affordable Care Act will only increase demand for nurse practitioners and physician assistants, who are already in demand because of a physician shortage and the growth of accountable care organizations, which are networks of doctors and hospitals that share responsibility for patient care to keep costs down.

"Nurse practitioners and physician assistants are attractive options, because they can do 75 to 85 percent of the work a physician does at 55 to 65 percent of the cost," Mesa said. "Research has also shown that use of advanced practice practitioners can improve patient satisfaction and health care delivery efficiency."

According to the Obama administration, more than 2.1 million people have enrolled in private health insurance plans by signing up on new state and federal websites since they were launched in October. The federal site, HealthCare.gov, handles sign-ups for 36 states. The remaining 14 states and the District of Columbia have their own sites.

"More insured people means an increase in the need for different types of health services, ranging from direct care to research and maintenance of medical records," Tony Lee, publisher of CareerCast.com, said in releasing a recent study on the need for more health care workers.

Last fall, the Joint Center for Political and Economic Studies, in a forecast on minority hiring due to the Affordable Care Act, projected the health care industry overall could add a total of 4.6 million jobs in the next decade, a 31 percent increase from the current level. The group estimated a third of overall hiring could be the result of changes due to health care reform.

In addition to biomedical engineering positions, CareerCast says, the health care professions most in demand this year will be dental hygienists, occupational therapists, optometrists, physical therapists, chiropractors, speech pathologists, pharmacists, podiatrists, respiratory therapists and physician assistants.

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Health care changes called hiring boost

Quality health care

My family will never receive the level or quality of health care that, for example, President Barack Obama or ex-Vice President Dick Cheney can obtain. Wealth and success can earn privilege. That is acceptable. My family has received coverage of average quality paid by combinations of out-of-pocket expense, private insurance and now Medicare with a supplemental policy. That, too, is acceptable.

There is another group in our society that lacks not just superior coverage or average coverage they lack the most essential health care coverages that would permit them to live with some degree of comfort and security. This is morally unacceptable. It is clear to a majority of residents that a healthy, educated society benefits all members.

We must expand health care coverage knowing it is a wise and ethical action.

Lawrence J. DellaMattera

East Newport

I was glad to see the Dec. 24 OpEd by Peter Mills and Sharon Tisher, Maine should lead Washington on climate policy.

Maine has a long history of protecting our environment: Sens. Ed Muskie and George Mitchell were critical in constructing the laws that protect our water and air nationwide. According to the American Lung Associations State of the Air 2013 report, nearly half of Maine people live in areas with unhealthy air. Air pollution causes tens of thousands of asthma attacks, emergency room visits, missed days of school and work, and can exacerbate and worsen other health conditions.

Maine is often called the tailpipe of the nation as much of the air pollution in Maine is blown in from the coal-burning Midwest. Because of that, we depend on the Environmental Protection Agency to enforce the laws that Muskie and Mitchell constructed. Now, we are depending on Congress to address carbon pollution and the devastating effects that climate change is already having on our state and nation.

In this time of partisan bickering in Washington, Maine is in a unique position to show the rest of the country whats at stake if we dont act on climate. Sen. Susan Collins has broken ranks with her party by voting against a measure that would prevent the EPA from regulating greenhouse gases. And just this week Sen. Angus King joined the Senate Climate Action Task Force. Our senators get it. Now its time for the rest of Washington to get on board.

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Tuesday, Jan. 21, 2014: Health care privilege, climate policy, emergency room care

Federal health care reforms are triggering dramatic changes in the health insurance arena. David W. Anderson is president and chief executive officer of HealthNow New York, parent company of BlueCross BlueShield of Western New York. He assumed the duties about six months ago. Anderson sat down with The Buffalo News Brian Meyer.

Meyer: Discuss the early impacts of Obamacare.

Anderson: The early phases for us started about 2 years ago. The market effect phases that were seeing now, which is mostly centered around the exchanges, are just coming up to the market now ... We are on the exchanges in both Western and Eastern New York. We have seen some new enrollment. Fortunately, the New York exchange models have worked pretty well by comparison to some of the federal exchange models ... But really, its just a little bit early to know just how its going to play out.

Meyer: You see insurers who have not been in this market before. More competition. How do you think thats going to affect the big insurers the ones who have had a real hold on this marketplace?

Anderson: Any market like ours welcomes competition. I think that, in the end, it is good for all of us and makes us better companies. The competition has really only existed on the exchange for the new entrants ... We have seen actually an increase [of more than 2,100] in our enrollment through the exchanges ... So I think that our experience as one of the longer-term players in the market is that we are getting more than our fair share.

Meyer: Talk about the challenge of walking the line between trying to control costs and preserve or perhaps even enhance services.

Anderson: Theres an interesting phenomenon in health care. And that is that higher quality almost always actually saves money. One of the things that were working with is how do we connect in a more effective way to increase the quality of care. To help eliminate unnecessary and duplicative care, such that we can control the costs that way.

Meyer: People are worried. You look at health care costs. Virtually every year, those costs are higher than the rate of inflation.

Anderson: And that process is not sustainable. Part of the reason the conversations [that were having with health providers] are happening ... is because it is known that unless we can get medical costs inflation down to a normalized rate of the rest of our economy, that its simply not sustainable. And that is the sole purpose of redefining the relationships between us and the health care providers.

Meyer: Looking ahead over the next year ... what kind of [rate] projections are we looking at?

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HealthNow’s David W. Anderson discusses changes in the health insurance arena

Topics: employment, gender gap, gender pay gap, healthcare

THE number of women in health care may be increasing, but higher roles remain out of reach with only a third of doctors and dentists being female.

Data on Australia's dental workforce released last week revealed women make up 37% of dentists, compared to 95% of dental hygienists.

Similar numbers were reported back in 2006, when women made up 36% of all medical practitioners compared with 99% of midwives.

Institute of Health and Welfare spokesman Dr Adrian Webster said the gradual breakdown in gender stereotypes was repeated across a range of industries.

"It's something we're seeing across the board in different health professions, GP, specialists, and more broadly across other professions outside health care system where they were traditionally male dominated," he said.

Gladstone Women's Health Centre manager Sandy Prizeman said the gap between men and women in health care professions was reflective of a social attitude.

"I think we have a social stigma that women are not quite equal to men," she said.

"If you work in healthcare, typically you'd be a midwife, but the reality is you could be the doctor delivering the baby, or the midwife in charge."

However figures are improving slowly with a 2% rise in the number of female dentists from 2011 to 2012.

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Women still hitting the glass ceiling in health care jobs

HEALTH CARE: ER study identifies states shortcomings

Georgias emergency rooms are facing a shortage of specialists, increasing patient need, and policies that create barriers to emergency medical care, according to a just-released report card, Americas Emergency Care Environment, by the American College of Emergency Physicians. Overall, Georgia earned a near-failing grade of D+ for support of emergency care and ranked 29th in the nation.

For Access to Emergency Care (part of the overall grade), Georgia ranked 46th in the nation, reflecting shortages of emergency physicians, neurosurgeons, orthopedists and registered nurses, among others. In addition, the state has too few physicians accepting Medicare patients, a high rate of pedestrian and bicycle fatalities, poor access to mental health care, and a high uninsured rate: 22.2 percent of adults and 10.9 percent of children.

As an ER doctor, I continue to strive to give the highest level of care possible, despite the struggles with the system. However, weaknesses in our emergency care system are not something any of us can afford.

DR. DARRIA LONG GILLESPIE, Assistant Professor, Emory Department of Emergency Medicine

2ND AMENDMENT: UGAs firearms ban may have saved lives

During my 30 years of teaching at the University of Georgia, from 1980 to 2010 and until now, there has not been a single murder by a firearm on our campus. I credit this excellent safety record to the universitys Firearms, Weapons and Explosives Policy.

Allowing students with permits to carry concealed guns is extremely reckless, given the high incidence of gun violence against women in Georgia. According to Georgias 2012 Domestic Violence Fatality Review Report, 46 percent of victims began their relationship with the person who eventually killed them when they were between the ages of 16 and 24.

Would you want to send your daughter into an environment where a rejected boyfriend might kill her with a concealed gun? The excellent safety record on the University of Georgia campus is a case in point that gun restrictions do protect women and save lives.

FRANCES VAN KEUREN, LAWRENCEVILLE

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