Long Road Ahead

There may be some hope for those looking for a more rapid boost in the healthcare sector, or at least part of it. A June analysis by Forbes and CIT found that for middle-market healthcare companies—for-profit hospitals, group practices, medical device makers with annual revenues between $25 million and $1 billion—60% of executives surveyed expected revenue to grow in the next year. More than 40% of those survey respondents also expected their capital expenditures to increase within the year.

Another factor in the length of the healthcare downturn may be gauging the effect of the stimulus package. While the IT provisions will start pumping the HITECH Act's $19 billion in funding into hospitals and health plans in 2010, some have charged that the ARRA's provisions meant to fund state Medicaid programs—and by extension the hospitals waiting to be paid—were circumvented by states for other uses.

And the unknown factor with the largest potential to accelerate a healthcare recovery remains the health reform debate in Washington, with the possible impact of a public health plan or other mechanisms of expanded access that could speed the end of the healthcare downturn.

"We have had 13 recessions since the 1940s," Keckley says, "and nothing parallels this. This is no-man's land. We've never been here before."