The Affordable Care Act, know as Obamacare, celebrated its 5th anniversary on March 23.

Juxtaposed to that is Match Day which was on March 20th: a significant day when medical students find out where they will go to learn the real skills of being a doctor.  According to Shara Yurkiewicz, who matched at her first choice of Stanford rehabilitation medicine, this was the largest match ever, with 41,334 applicants, of whom 34,900 submitted a rank list, and 75.2% matching.

Match day is a day of promise, a day of excitement, and a day of disappointment.  Little understood by the participants is the fact that it all really doesn’t matter. One educates oneself.

The education continues as being a doctor and having doctor skills flows against another set of numbers as represented by statistics touted as success of the Affordable Care Act. 40 million people are uninsured, while in 2010 there were 50 million uninsured. Favorable opinions have declined about the ACA and now it seems the unfavorable opinions outweigh the favorable ones. Kids are legislated to be covered by their parents until they are 26. Smokers can be charged more, and end of life counseling is paid for.

The irony that the challenge new doctors will face and the challenge the country will wrestle with is that sooner or later, we all run out of money. “Death panels” can be overt, or be part of a hidden agenda toward quality. In the past, despite insurance, no one, ever, was denied care. Can it be denied now?

It is our responsibility as citizens, and very much the responsibility of the newly matched doctors to be sure that the patient comes first. It is part of the Hippocratic Oath which they will recite in a couple of months as they are sent on their way to become the apprentice journeymen of a system in disruption.