unmair127, answer me this - why do 87% of physicians on Sermo hate the ACA. It's not because 87% are Republicans. They're not tea party. They're not bigots. They're not fearful of a Muslim president. They're not afraid of the illiminati. It's not any of those silly things certain elements in the media wants people to think that those who oppose Pelosi/Reid believe.
It's because physicians are the one providing the healthcare. We did the training. Some of us do the billing. Some have seen where it was and can see where it is going.
Fundamentally the ACA did nothing to reign in costs - instead it allowed insurers to swell up costs 200-500% in anticipation of painful patients - the one with full blown AIDS, the ones with type II diabetes who have sugars running in the 500s and have never had an A1C, the Hepatitis C patient who is finally tired of being yellow because now he can't stay awake. When you add these people to the rolls and the lawsuits start pouring in then insurers will need to have massive legal teams to fight back the trial lawyers.
And if you didn't think trial lawyers won with the ACA passing, ask yourself why MICRA is suddenly coming under massive attack in CA. It's Episode 5 - The John Edwards Strikes Back!
If you want to have an intelligent discussion stop playing pom pom cheerleader for Obama. The man is clueless when it comes to healthcare - his only experience to healthcare was appointing his wife to that 2 year position in Chicago where she made a nice $450K a year as a hospital admin denying Medicaid patients from the hospital. She's a beauracratic pig. He got her the job. Most private cardiologist don't make $450K and she sure as hell was never on-call.
If you want a frank discussion, point out the single most important element in the ACA that restructures the way healthcare is delivered. I can't think of one.
If you want a blatant criticism - midlevels are becoming increasingly common as the sole provider in clinics and physicians are giving them the name of Noctors. The government is pushing for people who are as skilled as physicians but as cheap as a basic RN (not a high RNP or skilled PA that does surgical assist). Why did Congress not appropriate a single increase in primary care residencies in the last 10 years (yes, under Obama and Bush)? Why did Congress not increase training options for something between a doc and NP - something with 2 years of training and 1.5 years of clinical training with low debt?
You can't just give everybody in America $1 million dollars and say "everybody gets a Lamborghini" - it doesn't work that way.