Obama care is here and the clinics and hospitals are already preparing for how they will accommodate the millions of people currently without health care who will be asking for free care soon. The Supreme Court’s decision to approve health care for all may have settled the issue of the plan following the Constitution, but for millions of Americans, many questions remain. What is really going to happen?

Many hospitals are seeking survival in the new world of the Affordable Care Act which is President Obama’s health Care Law. Lets use Hackensack University Medical Center in New Jersey as a example of what many hospitals are already doing. They started as a 800 bed hospital. Now they have acquired 2 additional community hospitals and are affiliated with three hospitals. They have been working on the expansion for two years and believe that bigger hospitals is the way to survive; so there has been a recent frenzy of mergers and acquisitions with hospitals and clinics.

Why? Money. Under the new health care law, reimbursements for Medicare which covers senior citizens, Medicaid which covers the poor , are being slashed so health care providers seek consolidation as a way to cut the cost that eat up what they get.

There is going to be a patient satisfaction form or survey all patients are suggested to fill out called the HCAHPS Survey. It is a patient satisfaction survey. For Medicare patients, the more positive response to the questions, and the better their treatment outcomes, the bigger the hospitals reimbursement. So, you know those surveys will be everywhere.

Medicare covers 40% of the Hackensack Hospital’s patients so, tens of millions of dollars are at stake there. Americans like the provision allowing children to stay on their parent’s insurance until age 26. We also like that insurance companies can no longer refuse coverage for preexisting conditions or cap lifetime benefits. But, cost containment, one of the goals of health care reform, is insignificant.

According to health policy expert Robert Lefcheski, “We have a health care system that is bankrupting us. The cost of health care is growing at 3 times the rate our economy is growing.” In just over a decade, the average annual medical cost for a family of 4 in 2001 was about $8,000 dollars per year. In 2012 the cost for the same family has grown to $21,000 dollars a year, more than doubled in price. That includes employer and employee premium payments and as well as out of pocket costs according to the Milliman Medical Index.

We can’t afford our current health care system so what the Democrats are trying to do is to essentially load more people onto the sinking Titanic. President Obama announced,” If you are one of the thirty million Americans who don’t yet have health insurance, starting in 2014 this law will offer you an array of quality affordable private health insurance plans to choose from.” Thanks bro, but who is going to pay for all these people that have nothing now?

Still, it is estimated that 16 Million people won’t be able to afford private insurance. Already hospitals are getting millions of dollars if they can prove they have a lot of Medicare patients and clinics are receiving money for the more families they sign up. The biggest problem is whether they get the money or not. It largely depends on how the political battles are going. Republican states are opposing the expansions.

Now we have a new Supreme Court ruling that says states have the right to opt out. So, be careful what state you get sick in. You might get care for free or you might not get any care at all if you don’t have that insurance card ready. The Republican Governors who wanted to get out of Obama’s health care now can turn down what looks like nearly free money from the government for their states hospitals and clinics.

The Federal Government would pay nearly 100% of the medicare expansion costs for nearly 3 years now and 90% after that. It is still up to the voters to pass judgement and Mitt Romney said, “I will act to repeal Obama care on my first day of office” I guess Obama was pretty sure he would be reelected. This mess is not over yet.