Richard Armstrong, MD shares his thoughts on what physicians must do following the King vs. Burwell ruling by the Supreme Court of the United States:
The government is on a fantasy fiscal trajectory and they have been for 5 decades. MACRA accelerated it, but it allowed Congress to wash their hands of the issues for about another decade. This SCOTUS decision simply says that the government can “allocate” about another $700 billion to subsidize health care spending over the next decade…roughly.
Since 1990 the percentage of GDP allocated to all federal spending has remained relatively constant. However, in 1990 1/3 of that spending was on “entitlement” programs. By 2015 the percentage has increased to ½. The projection is that by 2030 the percentage will be 2/3. Spending on entitlements will crowd out everything else.
This is not financially possible, but neither party has a plan to address it…at all. It is politically untenable. So, today the Republicans will shriek for the cameras and breath a huge sigh of relief in private.
What to do? Enter the market with better models. Be excellent at doing that and attract patients to the models we build. Work to identify the barriers to market entry and either bypass them or eliminate them altogether. Think of state CON laws and the bans on physician ownership of facilities.
Many are already at work doing this…like Keith Smith. We need thousands of Keith Smiths and we need to partner with business and industry to do this. They are hurting as well.
The market for health care innovation is huge, and the government is on a trajectory to failure. We need to stop looking to the politicians for leadership and help.
They need to learn to look to us.