What about the doctors?

The Supreme Court decision is the talk of the town. Everyone is positing the impact of the decision on the pharma and medtech industry, payers, hospitals, insurance companies and states. But, where are the patients and doctors in all of this? Once again, the two most important players in the healthcare system, the doctors and their patients, are getting short shrift.

No one can predict the outcome of this piece of legislation, which does little if anything to address the cost or structure, process or outcomes of care but instead focuses mostly on access and financing of care. Here is my look into the crystal ball as to what it will mean for doctors.

1. It depends on where and how you practice. Docs will figure out how to maximize their payer mix.

2. Having insurance does not mean getting access to care. Just ask existing Medicare and Medicaid beneficiaries trying to find a doctor to take care of them.

3. Boosting immediate demand for services with a workforce supply that takes 10 years to expand will result in increasing existing efforts to ration care, either overtly or covertly, like we do now.

4. States will sell their souls to grab federal Medicaid dollars for the short-term gain. They will then be stuck with the bill when the federal money runs out with resultant increasing cuts in reimbursement for services.

5. Unintended consequences might increase the cost of care despite attempts to create efficiencies.

The expansion of digital health, care delivery and process innovations will continue to evolve led by entrepreneurs and market forces. Even the Supreme Court of the United States can't stop that.


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