By Stephen Tweed Sitting on at airplane this afternoon on my way to Atlanta, I saw an interesting tid bit under the title, "Notable and Quotable". The writer, Jonathan Tobin, said "there may be some voters who are indifferent to the impact on the economy of health care reform... But will they stand for an increase in the price of Pizza". Then he goes on to quote our neighbor here in Anchorage, KY, John Schnatter. John is Papa John of Papa John's Pizza. John says Healthcare reform will cost his company 11 to 14 cents per pizza, and 15 to 20 cents per order filled. John says that "the Obamacare government surcharge will be passed on to consumers". That raises the question of how much the new law will add to the consumer's cost of a Big Mac, or a Coke? Tobin suggests that this across-the-board surtax on virtually all expenditures will hit the poor a lot harder than the rich. So what impact will this have on us in home health care, hospice, and private duty home care? Well first, the cost to provide insurance for our employees will go up. Then the cost of everything we buy will go up. In home health and hospice, we won't be able to pass it on to consumers, because Medicare and Medicaid pay the bills. Half of the cost of health care reform is being paid for through reductions in payments to health care providers including $500 billion in Medicare cuts. For private duty home care, the added costs can't be passed on to Medicaid Waiver, so they will be passed on to private pay consumers. How much more will you have to charge per hour to pay for the added costs? Reading this brief quote from Papa John has causes me to question how much cost we will have to pass on to you, our consumer, when you attend a seminar, when you attend your state association conference, when you register for a webinar, or when you buy an eBook. When you throw a pebble in a pond, the ripples continue out to the edges of the pond. What will be the ripple effect of paying 15 cents more for Pizza to cover the cost of healthcare reform? I'd love your comments on this concept.