Health care. And the luxury tax.
And no, we're not just talking about the Earl Anthony of the NBA, enigma-turned-bowler Andrew Bynum.
But that's where we start. Because that's now where the 76ers have to start.
For as much as Bynum's injury rehab, or lack thereof, has created questions in Philadelphia about the offseason trade that sent Andre Iguodala to Denver (and re-routed Dwight Howard to L.A.), the 76ers now how an even greater one to chew on:
Is this a player they can afford to sign to a megabucks deal amid this final year of his contract?
At the time of the trade, the question was not if Philadelphia would offer the max, but rather whether Bynum would be willing to commit long-term to a team with a somewhat suspect supporting cast.
But the NBA is changing. A new, more punitive luxury tax that will go into effect after this season will magnify even the smallest of mistakes, let alone those made with non-ambulatory max players.
Might a healthy Paul Millsap or Al Jefferson make more sense for the $10 million in cap space the 76ers might otherwise have this summer?
The NBA no longer can afford Sam Bowie-like risks.
If you haven't noticed, Greg Oden didn't even get a whiff during free agency, not even offered the ride-along program Eddy Curry got last season with the Heat, one that came complete with glossy championship ring.
Where there previously had been ample relief options with injured players, that no longer is the case. They may not play, but you still have to pay, luxury tax included. And the list of remaining eligible amnesty players is miniscule, that escape hatch also effectively closed.
It is why the Suns might actually have come out ahead when the Hornets matched their Eric Gordon offer sheet, Gordon yet to make it to the court this season because of his ongoing knee issues.
Similarly, one has to wonder whether David Kahn would have done now what he did then in offering Brandon Roy $10.5 million for two years during the offseason. The knee problems that led to his amnesty from Portland and then yearlong hiatus have only led to another round of surgery.
Beyond that, there is the curious case of a Knicks team that has proven better without Amare Stoudemire. So perhaps a trade? Not so simple when considering Stoudemire not only has four years and $64 million left on his deal, but that the contract is not insurable because of his injury history.
For the most part, teams have placed a higher value on potential payoff on the court than possible injury risks, at times signing off on accepting players barely ambulatory. If Bynum is Example A, then Example B might be Golden State's Andrew Bogut, who is now rejoining his latest round of injuries woes already in progress.
Rare are the types of cases where the Timberwolves went back and filed an injury claim against the Trail Blazers because of Martell Webster's back issues.
But Bynum could change the reward-risk thinking with sketchy medical histories. Because now it's not just one knee, it's two. And it wasn't just the offseason trip to Germany for therapy, it was the recent trip to the bowling alley that exposed a new round of issues.
"I have issues with my knees, and we're going to have to try and resolve it," he said in a moment both of candor and concern. "There's really nothing to do. There's no surgical procedures that would really help or are safe to do at the moment. So I've just got to kind of bide my time."
For the 76ers, it is difficult to envision a Plan B. If the injury concerns reduce their offer, it is likely another team will take the risk, because the Knicks took the risk on Stoudemire, the Warriors on Bogut.
Height has a way of seducing. Just as it did with Bowie. Just as it did, at least briefly, with Oden.
But because we're seeing what has transpired with Roy, there also figure to be a lot more Shaun Livingstons in coming season, injury risks finding teams not willing to offer much more than the minimum, and without any guarantees, almost NFL-style contracts.
While Gordon still could come around and form a potent 1-2 punch with Anthony Davis in New Orleans, he also now could be a four-year, $58 million albatross that inhibits the Hornets' future with Davis.
Granted, even the severest of NBA injuries hardly mean the expiration of careers. Derrick Rose will make it back, as will Ricky Rubio. And Steve Nash has been dealing with a balky back for years, as certainly may be the case going forward with Howard.
But with a luxury tax that could inflate the overall cost of a player's contract to more than triple the actual salary figure, you're going to need at least 60 or even 70 games a season, plus payoffs, to make sense of any such layout.
A simple trip to the bowling alley raised the risk for the 76ers. Who knows what happens when Bynum's co-ed curling league begins play?
In the NBA, universal health care already is in place. No expense is spared when it comes to rehab.
But should the rehab fail, that's when the bill truly can come due, an onerous luxury tax that can lead to treble damages or even more.
NBA general managers may not be doctors in real life, but more and more they will have to play one when it comes to deciding where dollars most efficiently should be spent.
Ira Winderman writes regularly for NBCSports.com and covers the Heat and the NBA for the South Florida Sun-Sentinel. You can follow him on Twitter at http.//twitter.com/IraHeatBeat.
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