Sixteen Imprecise Predictions about Obamacare ‘s Future

 The problem of predicting the future is that it involves the future.

Anonymous

No one knows with any precision about Obamacare's future.   There are too many variables and forces at work. I  make these uncertain predictions with the  certainty that they may be wrong.  This is not about exactitudes, but trenditudes

1.       The health law will remain in effect until 2016, as long as Obama is President.

2.       Republican repeal  or defunding  Obamacare is symbolic, since the President will veto any repeal.

3.       Certain ACA provisions, medical device taxes on revenues and obligatory coverage of businesses with over 50 employees, will be dropped or modified.

4.       The Obama campaign will spend more than $700 million to woe the young and healthy to sign up for exchanges with indifferent results.

5.       The nation’s one million physicians are an insignificant political force compared to 50 million seniors on Medicare.

6.       Physicians’ political power resides in  dropping out of Medicare because of low payments but physiian sare unlikely to exercise this power because politically physicians tend to be passive.

7.       The November 2014 elections are important in that they may return the GOP to power in the House and the Senate, but there will not be enough Republicans to override an Presidential  veto.

8.       Obamacare support among moderate and conservative Democrats and unions will continue to erode as its unworkability due to delays, glitches, missed deadlines, and skyrocketing costs becomes evident.

9.       More doctors, perhaps 10%, will opt out of Medicare, another 20% will cut back on seeing new Medicare patients,  and  50% will not accept Medicaid.

10.   More doctors in affluent areas,  in the 15% range,  will enter concierge and cash-only practices.

11.   Health savings accounts will continue to grow at 25% per year until they reach 60 million members by 2020.

12.   Patients will continue to flock to retail clinics, urgent care centers, and independent free-standing emergency facilities for convenince and lower costs.

 

13.   Specialty centers,  owned by hospitals, co-owned by hospitals and specialists, and owned by specialists, will proliferate, partly in response to accountable care organizations.

14.   Nurse practitioners will gain autonomy and primary care physicians will autonomy.

15.   Hospitals and integrated health systems will be the dominant providers in most regions with employed networks of physicians.

16.   Young physicians,  50% of whom will be women,  will gravitate towards employment and balanced life styles.

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