The New Yorker this morning has an article by Atul Gwande MD with that ominous title.
Pumping up the rhetoric seems to have been the present outcome of the Supreme Court Decision about the Patient Protection and Affordability Care Act.
Here comes the list of the present ‘winners’ and ‘losers’
THE MORNING AFTER
It's the bitter pill 24 hours after the supreme court decision(s) on PPACA.
The decision leaves a trail of winners and losers, from Main Street, USA, to the very steps of the Supreme Court. For some, it's a mixed bag. Here's a look:
WINNERS
Casey Quinlan, a 59-year-old breast cancer survivor who lives near Richmond, Va., and millions of other uninsured people. Starting in October 2013, the uninsured will be able to sign up for taxpayer subsidized coverage either through private insurance plans or the Medicaid health care program. Coverage commences on Jan. 1, 2014. The law eventually is expected to provide health insurance to about 30 million of the estimated 50 million uninsured Americans. Insurers will not be able to turn away people with a history or medical problems, or charge them more.
Hospitals. Their stock zoomed Thursday after the Supreme Court ruling guaranteed them millions more paying customers. Some analysts expect the law to reduce uncompensated care losses borne by hospitals by about half. Currently about one-fourth of the care provided by hospitals is never paid for, either because debts can't be collected or the patient is uninsured.
Stocks of big laboratories also rose.
insurance companies had a see-saw day, down sharply at first but recovering some lost ground. They'll get millions of new customers also, but they face new federal regulation and taxes they fear will drive up costs.
Family practice doctors. The law provides a pay boost for those treating Medicare patients, and takes other steps that could make general practitioners the new gatekeepers of a more efficient health care system.
Democrats. President Barack Obama and former House Speaker Nancy Pelosi devoted a vast amount of his first term to passing a health care law that has divided the nation.
Solicitor General Donald Verrilli Jr. Obama's top Supreme Court lawyer was maligned for his performance in both the health care and Arizona immigration cases.
Chief Justice John Roberts - The darling of conservatives, Roberts finds himself in the unusual position of being praised by the left and criticized by the right following the health care ruling,
The National Federation of Independent Business. The law imposes fines on employers that do not offer coverage, but companies with fewer than 50 workers are exempt,
Republicans. From presidential candidate Mitt Romney, to congressional leaders like House Speaker John Boehner, R-Ohio, and Senate Minority Leader Mitch McConnell, R-Ky., it will get harder for Republicans to argue that the law should be wiped from the books. However, Republicans could regain the upper hand by targeting unpopular provisions for repeal, like tax increases on industry, cost controls and cuts to service providers.
States that didn't prepare. About half the states now find themselves in the position of the little piggy that built his house out of straw. Many Republican-led states held back on carrying out the law's plan to set up new insurance markets, confident the Supreme Court would toss out the whole thing.
Justice Antonin Scalia. He sat glumly and silently as other justices read their takes on the health care law. Scalia was more vocal than any justice in his distaste for the law
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