What Does ObamaCare Mean To Physicians, Hospitalists and Hospitals (And Everyone Else)?

On June 28th, 2012, ObamaCare was upheld almost in its entirety by the Supreme Court.  Ironically enough, On June 28th, 2012 I learned from a Medicare patient in my home town that they could not find a single internist or family medicine physician that would accept new Medicare patients. What does ObamaCare mean to Medicare patients?  It means physicians, already shunning the low pay of Medicare and Medicaid, will probably accelerate the transition of their practice toward a younger and  healthier population that pays better with  less time and effort.

Good luck Medicare patients.  ObamaCare has just turned the ER into your primary care physician.  In-patient hospital care by hospitalists should see parabolic growth as access to care by Medicare patients rapidly deteriorates.   But,  before you can get the ED doctor to see you, you'll have to wait in line for all the Medicaid patients to move through triage first. They were there first.

But what about physicians?  What about outpatient general care doctors, family medicine doctors, internists and other primary care physicians?   What about the cardiologists and nephrologists and gasteroenterology physicians?  And don't forget about the radiologists, anesthesiologists,  endocrinologists, allergists and infectious disease doctors.    And the general surgeons,  orthopedic surgeons, urologists and ENT docs.  And the chiropractic, accupuncturists, reiki experts and palm readers.  What does ObamaCare mean to them?  

If you're a pharmacist, physical therapist, occupational therapist, nurse or respiratory therapist you're probably wondering by now what ObamaCare means to you.  Perhaps you are a lab technician or a radiology technologist working at an outpatient microbiology lab or in a CT and MRI suite.  Or perhaps you are a social worker or CEO of a big hospital system. Or one of the millions of administrative specialists with made up titles pushing paper from one committee meeting to the next.  Or an information technology and software specialist who hides behind the woodwork, ready to pounce (within six hours) on the frequent expected and unexpected EMR failures that happen in the middle of rounds.    What does ObamaCare mean to you?

And the medical device manufacturers, drug companies, durable good manufacturers, home health care agencies and oxygen suppliers?  What does ObamaCare mean to them?  Nursing homes?  Assisted living facilities?  Veterans?  Active military personel?  What do these new regulations mean to their access to care.  And the lawyers? What does a mandate to buy insurance mean to jury awards for medical bills if all patients are required to carry their own insurance?  What does it mean to malpractice insurance rates ?  What does it mean to salaries? What does it mean to the hours you work and the benefits you receive?   What does it mean to your family?  What does it mean to your job security?  What does it mean to your future?

Great questions.  If you came here looking for answers, I don't have any.   I'm just not that smart.  Health care in America is a 2.5 trillion dollar growth engine.  It represents over 15% of our GDP.    It drives creativity, innovation and industry.  Health care, for decades, has been a respected career opportunity for young graduates looking for a comfortable life and retirement.  

That all changed on June 28th, 2012.    We are currently living in the greatest financial depression and asset class destruction in 70 years, driven by a debt fueled credit bubble of epic proportions.    There is nothing neither Republicans nor Democrats can do to prevent it.    Americans have lost nearly 40% of their total personal wealth in the last 5 years.   It started in 2000 with the collapse of the NASDAQ bubble and it has continued for the last 12 years.  It has a few more years to go.

 It is not over, no matter how much the Federal Reserve tries to expand the money supply .  That money is going no where.  Money velocity continues to plummet.   The Kondratieff Winter seems to be playing out as planned, no matter how bad the central bankers try and prevent it. The end game is being witnessed in Europe.  There is nothing stopping its arrival to America.    All bubbles must come to an end.  It's only getting worse.   Pension bubble.  Health care bubble.  Higher education bubble.  It's all coming.  They are all going to be painful when these balloons pop.  Whether you are a net winner or loser depends on what you had to begin with.   You can't lose anything if you start with nothing.

Perhaps history will look back and define ObamaCare as the flame that lit the fire on the beginning of the largest health care depression that ever existed.   It is simply impossible for the government to backstop health care for everyone,  at deflation level prices, promise to eliminate all barriers to care, and then expect the health care industrial complex to thrive.  For health care, the end game is here.

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