Every hospital in the United States is now trying to figure out a strategy for breaking even on Medicare patients in the coming years—with or without healthcare reform. Medicare may go bankrupt by 2019, as currently projected, but regardless, the number of Americans over age 65 will more than double by 2020—up from 41 million today to around 120 million in eleven years. No healthcare providers expect increases in Medicare reimbursements. As Medicare rises from 30% to perhaps 70% of the patient mix, thousands of hospitals and nursing homes will face insolvency. One might suppose that seeing this train wreck coming, some body will do something before it hits. But the history of the “baby boomers” suggests that most of the predictable crises in their experience actually happened. This is not to say nothing can be done. Any good idea that can demonstrate savings of as little as a 4% in Medicare costs—such as telemonitoring to prevent hospital readmissions—has excellent prospects for becoming reimbursable. Meanwhile, though, time is fleeting and we can almost hear the thunder of wheelchairs and walkers.