Election Results Analysis…One Day Early

Futurists are expected to step out on a limb, so I’ll daringly interpret the results of the mid-term elections before the votes are cast and counted.  I’m totally unwilling to say who will win because this election is like no other.  However, my crystal ball (I really do have a crystal ball on my desk!) gives a pretty clear picture of how the final tallies will affect health care for the next two years—no matter who is elected.  The dynamics of this election foretell much more than the winners.

First and foremost, the campaigns and the candidates suggest to me that the two parties are badly fractured, if not irreparably damaged.  Neither the Democrats nor the Republicans are likely to be cohesive political forces when the next Congress convenes in January.  Internal divisions within the parties will probably create more gridlock than differences between the parties.  In the likely event that Republicans gain control of the House of Representatives, rifts between Tea Party loyalists and traditional party leaders will seriously complicate efforts to “repeal and replace” the reform laws of 2010.  The most probable outcome will be failure to appropriate program funding authorized by the laws.  ObamaCare will largely remain the law of the land, but it will not be funded at anything near the anticipated levels.

In the unlikely event that the Democrats retain control of Congress (about equal to the unlikely event of the water landing that flight attendants mention before take-off), the most probable outcome is slightly different.  Many Democrats who supported the 2010 laws are likely to push for changes in the laws if they are reelected, but appropriations are still likely to fall short of authorizations due to the a dismal economic situation and Democratic concessions to control deficit spending in order to get reelected.

In other words, I expect that the election’s impact on health care is pretty much the same no matter which party wins, albeit for different reasons.  The federal government’s future contribution to the health care “pie,” 17% of the GDP, is fixed at best—especially because consumer purchasing power is not going to grow to make up the difference.  Those of us in the provider and payer communities have no choice but to do a better job with our current resources.  Growth is not an option for the industry as a whole, although it is a possibility for progressive organizations that learn how to do a better job when their competitors do not.  Reforming business processes is the no-lose response for providers and payers who plan to survive and thrive in a market that will be unforgiving—no matter who wins next week.

What do you see in your crystal ball?  Here’s your chance to be a futurist, with the attendant risks and rewards.