Now that President Obama has won re-election, ObamaCare will be the law of the land.

Kaiser Health News quotes health care consultant Dan Mendelson, " It’s full-steam ahead with implementation ".

For two good round-ups on what that means

Modern Medicine, " Obama's re-election ensures continued rollout of Affordable Care Act measures in 2013 "

Politico, " Obamacare survives -- now what? " 

Some of the key changes will include the rollout of state health "exchanges", the enforcement of the individual mandate, and the shift towards "bundled payments" for doctors and hospitals.  The potential Medicare cuts under budget "sequestration" could also be an enormous issue.

Dr. Marc Siegel summarizes in, " What Obama's victory means for your health care -- a doctor's take "

Prices will continue to rise and access to actual care will decline in an already overcrowded system.

Biotech companies and drug companies may feel that the climate is no longer ripe for innovation.

Hospitals and other health care providers will continue to struggle amid shrinking reimbursements.

Bottom line: my patients who gain a new insurance card may find that it doesn't buy them the care they were expecting.

I also anticipate some critical flashpoints will be Health Savings Accounts (HSAs), concierge physicians "opting out" of the system, and the scope of "practice guidelines" for physicians remaining in the system.

Stay tuned for more.