Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.
Medical services are already rationed, and not only due to cost. Sheer futility rules out some operations... like liver transplants for current heavy drinkers with deep cirrhosis. Maybe a family that mistakenly ate some bad mushrooms gets them instead.
If medical costs keep rising and incomes fail to keep up then we can expect people to be priced literally into the grave instead of the hospital ward. Our current paradigm depends upon the idea that the way to perfect something is to ensure the maximum profit in the business -- competition and people priced out of a monopolized market be damned.
The blank check to hospitals, insurance companies, and pharmaceutical companies may prove unsupportable. As it is... medicine remains a highly-desirable career, and medical research is a good way of making a living. Don't forget that the tax structure in the US is physician-friendly.
Cost containment will be necessary for medicine that serves people. Physicians may have to devolve much of what is now 'their' turf to others who can do routine medical practices.
