Health Reform, Like Horse Races, Hard to Predict

Trends, like horses, are easy to ride, in the direction they are going.

John Naisbitt (born 1929),  author of Megatrends, (1982) and Mindset! (2006)

July 8, 2012 -  These days, the world of predictions divides itself into two camps,  prediction markets – betting sites like Intrade and Betfair – and the realm of inside experts – most notably the mainstream media and government insiders.   The prediction markets depend on the wisdom of the people, the inside experts rely on opinions flowing from inside the Beltway.

Both camps are flawed. Intrade gave the odds of the individual mandate being struck down at 75%.  The word among inside experts was that insiders had gotten to Chief Justice Roberts, causing him to switch his vote at the last minute.   Insiders said the public would ultimately embrace Obamacare.

Intrade now gives odds of President Obama being re-elected at 56.3%, while GOP partisan“experts” such as Dick Morris and Scott Rassmussen, citing polls of “likely voters,“ say it will be Romney in a walk.   Who knows?  Now that  the prediction markets have proven flawed, do we turn back to political experts – and to experts on either side of the political aisle?

Right now predictions among conservatives in, states like Florida, Texas, Louisiana, Wisconsin, and a handful of others will refuse to accept federal money for Medicaid expansion.   But liberal insiders say these states will cave once government waves billions of federal money in front of their noses.  And conservatives, in the face  of Supreme Court setback, are praying for a GOP sweep of the Presidency, House, and Senate will repeal of Obamacare.

In their case,  the reaction of physicians to the Supreme Court ruling has been “mixed,” with conservative physician organizations renouncing it, and the AMA and AAFP cautiously applauding it.   

Meanwhile certain physician health reform horses – the switch to electronic records, more hospital employment, decline of private practice – are moving steadily forward.  Among physician groups, the repeal movement is still alive, particularly in the House where it is being driven by Republican physician congressmen.  Among the people,  the sentiment and wisdom of the crowds,  is still for repeal, but as everybody knows, everything still pivots on the November – and the state of the economy and the level of turnout  on both sides.

All of this reminds me of the weather forecast for tonight  of  comedian George Carlin (1937-2008),

” Continued dark overnight, with widely scattered light by morning.”

Tweet:  Forecast for health reform, based in Supreme Court decision: “Continued darkness overnight, with widely scattered light by morning.”