Reform Now Past the Point of No Return

So no matter which way the political winds blow—they're at hurricane force now and gathering strength—there's no going back. Even in the unlikely event that the PPACA is repealed or otherwise weakened by Republicans after the 2012 elections, private market forces have also recognized the problems with value and quality. And that's a significant factor forcing change.

So never mind the government, says Peter Brumleve, chief strategy officer at Scott & White Healthcare in Temple, TX, and an advisor for the intelligence report.

"Regardless of whether [the PPACA] gets repealed or funded, private market forces will still act in trying to fix the fundamental issues in healthcare," he says. "So we look at the act as a stalking horse for what we eventually have to do as a system."

So despite the uncertainty and even fear about the future, healthcare leaders are getting on with the process of transformation.

Interestingly, at least for me, is the belief held by a majority of our respondents that the new landscape will offer better access for the majority of people to healthcare services. Before it was passed, the key attribute of the PPACA, at least from supporters' viewpoints, was that it would provide health coverage to the majority of the uninsured. Healthcare leaders remain unconvinced.

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