One - Can they grasp the “third rail” of American politics, entitlement programs, in this case Medicare and Medicaid which cover 100 million Americans, and which are poised to explode in growth by as much as 50 million for Medicaid in 2014 and to reach 76 million for Medicare by 2019, without being electrocuted politically? We shall see.
Two - Can they threaten the very survival of American hospitals, which derive 55% of their revenues form Medicare and Medicaid? This is why hospitals are spending $1 million a week to defeat the proposals.
Three – Can they maintain access of care in the states , already cutting back on Medicaid to balance broken budgets, to the most vulnerable – children, seniors, the poor, and the disabled, while causing more doctors to drop out of Medicaid and Medicare because of lowered reimbursements. I doubt it. Doctors surveys indicate as many as 40% to 60% of doctors may opt out of Medicare and Medicaid.