Health Reform Law: It’s a Long, Long Time from March to November

Oh, it’s a long, long time

From May to December

But the days grow shorter

When you reach September.

September Song (1930)

March 29, 2012 -  In politics, a month is a lifetime, and 7 months is an eternity.   It’s four months  from now to late June when the Supreme Court issues its ruling on the health law,  and it’s seven months until the election.  

No one knows what will happen between now and the election. But whatever occurs,  it will be a psychological and political time.  

Democrats will put on a brave face. They will say  it’s not over until it’s over and the fat lady sings, that the individual mandate was originally a Republican and Romney idea,  that the justices will come to their senses,  that this whole exercise is a moral not a constitutional issue.

Republicans will say that  the health law is  a train wreck, that it was rooted in ego and arrogance of an overly ambitious president,  that Democrats poisoned the whole politics process by completely  ignoring the other party and the American  public, and that the whole idea  of individual and Medicaid mandates is toast.

 If they are smart, and there is no guarantee of that,  the GOP  will issue a detailed alternative plan resting on incremental market reforms with proper government oversight.

“Inaction “ on Massive Scale

Over the next seven months,  we are likely to have “inaction,” if I may borrow a term from the hearings,  on a massive scale.   

·       The states, particularly the 27 who brought the suit to the Supreme Court,   will stall or stop implementation of health exchanges.  

·       The Obama administration  will  step back and concentrate on campaigning on other issues to divert attention from its failed health reform law.  

·       The Romney team will focus on economic growth to distract from Romney’s Massachusetts  health care legacy.

·       American businesses, large and small,  may hire at a modestly increased pace but will hold back because of continued uncertainty.

·       The Medical Industrial Complex- hospitals, physicians,  health plans, drug companies, nursing homes, rehabilitation  centers, drug  companies, medical device makers, and health IT companies – will continue to prepare for the nest millennium, with or without Obamacare.

Trends in Motion Stay in Motion

However,  certain trends in motion will stay in motion.

Paramount among these are:

·       Decline in private practice

·       Migration of physicians into concierge and other direct pay practices outside the province of 3^rd parties

·       Consolidation of hospitals, physicians, and insurers into bigger entities to fend off government  and for leverage to negotiate with government

·       Renewed emphasis by employers on health savings accounts,  high deductibles,  and other cost-lowering strategies.

·       Decentralization of the system into smaller units outside the hospital and other non-institutional settings.

·        Increased use of telemedicine  and technologies to monitor and reach patients  in virtual  non-face-to face ways.

·       Altered behavior patterns by physicians and patients alike, prompted and accelerated by  social media and health IT corporations, as the nation seeks  more sensible and affordable approaches to health care.

Tweet:  The likely demise of current health law will retard its implementation but will not reverse reform trends already in motion.