The job potential for AAs may diminish severely during the coming inevitable health care payment reform. Read A$A President Lema. The government and private insurers are not going to continue to pay huge sums of money to an MDA to babysit AAs. The A$A leadership seeks to branch out into the ICU to make up the cash shortfall. Lema foresees ratios far greater than 4:1 in an effort to protect MDA earning power. Good luck ramming that change in AA law through each state legislature. Some states are presently 2 AAs:1 MDA, Some are 4:1. The A$A will have to come up with way more PAC money to make ratio changes in A$A sponsored AA state law. Read Lema.