Being a nursing student and working in various clinical settings I have seen my fair share of uninsured patients in need of medical assistance (Just look at the statistics - it was estimated that 6.3% of non elderly Massachusetts residents were still uninsured in 2010, despite Massachusetts’ implementation of comprehensive health care reform to provide universal care for all state residents!) I understand the need for universal care, and the Affordable Care Act would work to provide care to all citizens despite chronic conditions, low income, or age. It is no secret that primary care is the key to prevention, and that preventive measures are much less costly than emergency treatment. Placing emphasis on health promotion and charging hospitals for high readmission rates would save money and prevent the occurrence of hospital acquired infections while promoting asepsis and proper hand hygiene. All in all I was in favor of the Affordable Care Act until I attended a seminar on cardiac care in Boston. The lecturer began addressing challenges associated with cardiac surgery, one in particular being the high rate of readmission within 30 days of discharge related to extensive healing associated with such an invasive procedure. One of the major issues the hospital is facing is related to cost of care for patients readmitted within 30 days. She explained the high probability that readmission would occur (procedure related or not) and that the hospital would be forced to pay for care of readmitted patients beginning in 2014. This got me thinking. Should hospitals be penalized for readmission rates? If so, how will this affect the care that the readmitted patient receives? How will this affect the care that I receive? I am now reconsidering my position on the issue. I believe that all citizens should receive equal care regardless of insurance, race, gender, or socioeconomic status…but isn’t there a better way?