Of course, you didn't have any of them specifically in mind, but they are the result of the demands you made years ago when first threatened by the ACA. You demanded a free market.

You argued that a free market encourages innovation. You argued that a free market encourages competition, and that competition is good for consumers. You argued that lower health care cost is the result of both innovation and competition.

Of course, you were right with your arguments and you were right with your demands. But, and here's the big problem, most in our industry weren't truly arguing for or demanding a free market. Most were really arguing for and demanding the status quo. Too many are still trying to operate in a pre-ACA manner, as if in a status quo bubble.

Time to move on

Folks, for lots of reasons, the status quo sucked; that bubble was burst a long time ago. Even if you are/were benefitting from the status quo, you have to realize it was never sustainable—again, for a lot of reasons.

A free market does encourage innovation; it forces change; it entices new competitors.

Those who aren't willing to change and innovate as they prepare to compete in our evolving reality are about to become a victim of the very free market they demanded.

Come out swinging

A free market is worth fighting for, but it means you have to wake up every day prepared to fight for your own survival and your own success.

It's time for a gut check, guys.

• What are you doing right now to innovate?

• What change initiative are you and your team working through?

• What competitive advantage have you created for yourself?

The answers to these questions will either add to your fear or make it go away. Which is it for you?

Game on.