We who work in healthcare need to know our future. The following are virtually assured consequences of Patient Protection and Affordable Health Care Act: expansion of both the bureaucracy and its complexity; government restrictions on what physicians are allowed to do medically; more underinsured Americans; greater focus on outcomes; the death of private practice; more hospital closings; less available liability insurance; and an increase in medical tourism. We must--as the Boy Scouts advise--"Be Prepared"!