There is a Chinese proverb that is both a blessing and a curse. The blessing is, “May you live in interesting times,” and the curse is, “May you live in interesting times.” All of us would like things to stabilize into a constant, comfortable and predictable environment for us to live our lives, raise our families and care for our patients. We are entering the most complex and challenging period that medicine has experienced since the 1960s when Medicare was introduced. From now on, everything we have come to know and are comfortable with in our professional lives will change.
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September 2011Much of this has to do with a law of nature, that of unintended consequences. It states that the desired result of an action, which may have been well intended, well thought out, and justified, may lead to future events that were neither intended nor foreseeable.
Unintended Consequences
The current health care reform bill, the Patient Protection and Affordable Care Act (PPACA), is well intended, has the input of many bright people and was justified because of our failure to provide health care equally to all Americans. Yet it may have the dramatic, unintended consequences of bringing about the demise of private health care as we know it, creating a monumental power struggle and laying the groundwork for a single-payer system.