The Other Healthcare Shoe Drops (Or doesn't)

Posted by Sten Westgard, MS

In case you haven't heard yet, the Supreme Court of the US did not strike down the individual mandate of the Affordable Healthcare Act (ACA, somewhat derisively known as "Obamacare").

From Chief Robert's opinion: ""We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation's elected leaders. We ask only whether Congress has the power under the Constitution to enact the challenged provisions."

The ruling: http://www.supremecourt.gov/opinions/11pdf/10-7081b2d.pdf

The opinions (very long, a set of essays for the ages, really):
http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

Does this really clear things up? Well, there are still a lot of other details that need to be worked out. The individual mandate provision hasn't even kicked in yet, that's 2014. So while this is one major decision, it's not the whole story on healthcare reform. Each time we think we've reached a defining moment, we realize that there are more defining moments to come.

How does this impact the laboratory? Expect more "More with Less" in the future. More testing, Fewer funds. More weight given to those test results, fewer resources and staff to run them. Accountable Care Organizations (ACO) and the bundling of payments will raise the stakes on the test results, as those results will not only determine the patient's fate, but increasingly also the health system's payment.

The politics are far from over - this will just unleash a new round.