Writing in summer 2010 for the prestigious medical journal Annals of Internal Medicine, Obama's former health care czar Nancy-Ann DeParle joined two of her White House colleagues in arguing that "the economic forces put in motion by [the Obama health care plan] are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger physician groups." (1) In the provocative but little-noticed article, DeParle said doctors who "accept the challenge will be rewarded in the future payment system" by changes likely to occur in how doctors are compensated under Medicare. In other words, doctors who consent to these new arrangements will see their incomes rise. "Physicians who embrace these changes and opportunities," DeParle writes, "are likely to deliver the greatest benefits to their patients, the health system, and themselves."
