The most discouraging moment for me at the HFMA annual conference came during a question and answer session with Tuesday keynoter, Sen. Bill Frist, M.D., the former majority leader. It wasn’t how Frist all but pilloried the recently passed reform legislation. It was an aside about he would not encourage his son to enter medicine. Frist comes from a long line of physicians, and while his political ego shone brightly during his talk, his medical world-view came thru loud and clear. No longer in politics, Frist serves on the faculty at Vanderbilt, and his analysis of the current health care environment reeked of rambling academia (tempered, thankfully, by oratorical showmanship).

Yes, reimbursements will go down. Yes, the states are broke and will be strapped to run the insurance exchanges that are the heart of the legislation. Yes, Medicaid lacks the information systems infrastructure to support a sudden influx of new enrollees. Yes, health care spending as a portion of the GDP is on an unsustainable growth curve. None of this is particularly new news, and it took the honorable Senator way too long to make these points.

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