The Supreme Court has spoken. The Affordable Care Act is upheld. So what does this mean for those of us actually involved in healthcare?
First, there is a lot of work to do. The Court has reached its decision with regard to the legal issues; what remains are the challenges of improving the quality of care, lowering its cost, providing access to those who need the care, integrating technology into work flows and relationships, and developing the workforce that can deliver all of this.
We have an aging population. That is simply a fact. Baby boomers are entering their most healthcare-intensive years. This will tax our capabilities: all medical students are exposed to pediatric medicine, but not geriatric medicine which can be much more complicated as it often involves multiple ailments. It will challenge our capacity: this demographic reality will push costs upward and stretch already overburdened facilities, payers, and providers. It will test our convictions: Will “choice” be sacrosanct if it pushes the system to the financial breaking point? Will end-of-life planning go from being derided as “death panels” to required prudence as the number of aged balloons? Will evidence-based medicine be able to stand when it goes against popular opinion of the vocal, voting senior set?