Imagine if health reform stakeholders attended a Thanksgiving feast, a Norman Rockwell-like scene of commotion might ensue. At first, hospitals and doctors might argue over which game to watch on TV. Or they might jockey for who gets to sit at the head of the table.
But once everyone is calmly seated, physician and hospital leaders all might express thanks, forgetting the pandemonium that preceded.
1. Hospital leaders would go first, giving a blessing that after a year of running red ink, 80% of them this year are back in the black with margins and liquidity returning to pre-recession levels.
2. They'd bow their collective heads in appreciation that median days cash on hand nearly doubled, from 90 days in the first quarter of 2009 to 150 days for the second quarter, higher than the historic long-term average.
3. As they took second helpings of cranberry sauce and stuffing, they'd remark how nice it is that a significant chunk of their investment portfolio had returned and that inpatient volume has started to go back up.
4. And after the wine was poured, they'd raise a toast in appreciation that the dreaded predictions of a much more serious season of catastrophic influenza—seasonal or H1N1—has yet to impact their facilities. At the table's other end, physician groups would say a prayer giving thanks for many blessings as well.
5. For starters, doctors would bow their heads that Congress is working to prevent the dreaded sustainable growth rate from taking effect, thus barring a 21% scheduled cut in physician pay and repealing a flawed Medicare payment formula, and also for removing drugs from the pool, that makes that repeal less costly.