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So who are the winners in all of this winners and losers doctor bill weakened mortar is president and CEO of -- mark Pennsylvania's largest insurance company.
And doctor Scott Gottlieb is a former senior policy advisor at the centers for Medicare and Medicaid Scott I will start with you.
What do you make -- -- decision did you get any surprises here.
By they get more surprised misled -- people -- expecting I was expecting of course to strike down an individual mandate and probably strike downtown along with it I think what.
Confused people -- -- of the court first ruled that this isn't attacks and then basically ruled that it was attacks and that's what confuse a lot of folks.
-- -- Well I was a little surprise as well I thought the decision would go just slightly the other direction.
But those in the industry have to move forward they've already been moving forward certainly.
Hi mark in the other health insurance companies across the country have to implement the law.
And so world.
-- moving ahead.
All right so and now you're leading hi I'm mark we should note that I -- turn to the -- of the winners and losers are because it was interesting in today's trading as.
The hospital stocks did very well they're gonna get some help here with all that debt they have the insurers did not do so well they're now going after it to -- student.
Neat I'm sorry higher requirements and -- spend more than money they make on customers.
So Scott -- first.
Who are winners who are the losers in all of us.
Well I think longer term patients are gonna be the losers in terms of not having access to the kind of insurance products they want to also think physicians are going to be losers physicians are gonna find themselves -- relationships where decapitated.
Most of the -- reforms in this legislation reforms -- capitation on physicians.
And the health plans to get rolled out in the exchanges are going to be fairly low commodity low low margin products if you will.
That -- gonna get control of utilization by either owning positioned vertically integrating.
Or rolling out very narrow network plans -- -- -- tight control of realization by basically only contract from the small number -- -- -- gonna find themselves -- relationships with they're owned by other entities.
And have their practice tightly controlled.
-- is interesting because it speaks to how the industry's gonna change because of obamacare the structure of the industry.
It's really being revolutionized here what do you look like and another five years.
Well I think you're gonna see continuation of consolidation.
Both consolidation with hospitals and physicians and physician groups.
Also I'm expecting consolidation on the insurance side.
Everybody feels like they need to be.
Bigger and better capitalize.
To deal with a world in which there may be a lot of risk sharing of that is the doctors and and and the insurers and hospitals working together.
To take more -- fixed price types of arrangements rather than being able to raise the price.
You know continuously year after year.
You know I'm very interested in the impacts on consumers.
Scott let's do.
You start on this one happens to bringing -- we've seen premiums double over the last ten years last year alone they went up 9% how bad getting get isn't gonna get -- -- premiums will continue to go up the only thing holding premiums in check right now as a bad economy utilization rates is so a solo.
If the economy where recovery utilization rates can start to go up again people -- that's gonna doctor and gonna see premiums go up.
-- -- -- -- -- -- I would agree with that that that has held -- utilization and and rate increases here recently.
If the economy were to rebound.
Things could kick back up again.
Ultimately it's my belief that the biggest shackle on cost increase -- health -- is more engagement of the consumer.
And and a small business.
Who can choose and and and create and if there's a competitive market place.
And people are spending more of their own dollars I think that can be one of the really important checks on the cost of health care.
-- they'll long way to -- that's for darn sure they have a lot we -- we surely is sure and dad looks like it's only gonna get more expensive from here.
Doctor -- and -- and doctor Gottlieb thanks to both of you for being here great information.
Thank you so much.