To state that significant healthcare delivery change is coming to America must be the understatement of the decade. National Healthcare Reform is, according to our federal government, going to be rolled out in the next few years and has been created as a way to decrease healthcare costs, provide increased access and improve quality of care. The financial costs of U.S. healthcare are indeed staggering. In America 2.6 trillion dollars are spent per year on healthcare related activities including physicians (550 billion), hospitals (830 billion) and pharmaceuticals (250 billion). This amount equals 17.6 percent of the Gross Domestic Product (GDP); the sum of all the paychecks made by every working person in America. This healthcare cost related to percentage of GDP rises yearly and 2009 saw the greatest increase in healthcare spending in memory. The cost of U.S. healthcare is greater than the entire economy of France. Some economists have suggested that when the cost of healthcare rises to 22 to 25 percent of GDP, the economy will begin to grind to a halt for lack of availability of investment capital. If this rate of spending continues, by 2054 the unthinkable happens, when 100 percent of GDP is spent for healthcare. It is obvious from these facts of life that the financial costs of healthcare are not sustainable and that a rationing strategy must be employed. Businesses, insurers and federal agencies are engaged in this rationing and many physicians are now seeing the results of these strategies.