[toomuchtodo]

I would also expect with healthcare reform for healthcare related payments to decline. Not to mention an aging population will see a decline in payment activity.

With that said, it'd be swank to move as much paper checking activity to ACH as possible for efficiency reasons, as well as credit card activity to ACH to de-financialize payments (finance absorbs too much of GDP IMHO).

[dragonwriter]

> I would also expect with healthcare reform for healthcare related payments to decline.

In general, more people covered by public and/or private insurance means more insurer to provider payments.

[toomuchtodo]

More total dollar amount, lower quantity of payments, no? As you're cutting out all of the admin overhead, billing here and there, everywhere.

[dragonwriter]

> More total dollar amount, lower quantity of payments, no?

Well, I mean, that depends on the shape of reform. If you mean what the ACA did, no.

Medicare for All? Maybe.

> As you're cutting out all of the admin overhead, billing here and there, everywhere.

A significant share, as I understand it, of that cross-billing is to get an official denial from a higher-priority payer to show to another payer; my intuition would be that more coverage and security of payments would, even in a move to single payer, increase final number of payments unless actual payments are grouped and consolidated rather than paid individually as approved.

[jessaustin]

I suspect you haven't worked in USA healthcare...