It's rainy outside.
The dog's hungry and needs to be let out.
I still need to shave and shower.
And yes, I'm going to work today.
They tell me the doctor Medicare cuts went through. You mean the AMA, with all their sound and fury signifying nothing, failed to influence our Congressional leadership?
Gee, who knew?
Folks, this was the plan. The cuts were supposed to go through. So look at it on the bright side. Our government just saved $250 billion!
And quietly, practices will downsize their nicest employees or close all together. Many others will speed up their flight to be bought by big hospital systems - but these hospital systems will be more selective when deciding who they admit to their ranks. Inner city hospitals, struggling for survival, will look to the government for more subsidies to meet their demands for survival. Government will comply to protect themselves. Big hospitals and health systems with lots of doctor-employees will point to the decreased revenue by their doctors, tighten their belts a bit more by maintaining their months-long hiring freezes indefinitely, and fail to give those productivity bonuses to their workers as their construction contracts for their additions continue to get paid as they get ready for the "Big Wave."
In business, nothing changes quickly. Especially big, money-hungry, bureaucratic machines. But the paranoia will grow amongst the administrative and medical supplier ranks as senior leadership looks to cut back. You see, doctors are just the first.
And then there's the patients. If you're in a big town, you won't notice the difference. That's because in the operating rooms, there will still be one nurse where there had been two. In the ICU's, your nurse will visit you a bit less, but thanks to electronics, she'll still be watching or listening for you. You might notice it's harder to understand the foreign accent of your doctor, but he or she will be pleasant. At least until the next doctor arrives on the night shift.
But for the rural patients. Best of luck. Hope you've got frequent flier miles or low mileage on your car. You're going to need it. I have no doubt that you'll be able to get a telemedicine doctor to see you, provided you have more than a dial-up connection and a new computer with a videocam. What, you can't afford one? Better ask the government for a computer, then, okay? And while you're on the phone, ask them how possible acute appendicitis will be handled, will you?
Fortunately, if you're below 65, you'll see the effects a bit later. But if you're over 65, better tap into your savings a bit, so you can pay to have a doctor.
That's just the way it's going to be.
Addendum: Some earlier takes here and here.