Is health reform exhaustion a pre-existing condition? And if so, will exhaustion be banned after health reform is passed? We can only hope. However, now that it is nearly certain that health care reform will pass, it's time to figure out what it will mean for all of us.
After the passage of the legislation, a few things will happen in the first year:
- Insurers can no longer put lifetime limits on your coverage. If you've never been seriously ill, this won't mean much to you, but in the case you get hit by a bus, it's surprising how quickly a million dollar lifetime limit can mount up. Now you would be covered no matter how seriously ill you get.
What will not happen as a result of health reform, is the collapse of the health care system as we know it, despite Limbaugh's predictions. As with all major legislation, it takes awhile for change to kick in. After the first year, it will take a few years to phase in the remainder of the reform - the health insurance exchanges, the rest of the insurance reforms, changes to Medicaid (expansion of the program to include all poor adults not just women and children). There will be little if any noticeable change in Medicare - the changes that will occur will happen on the provider side, where managed care plans that serve the elderly will have to compete for business and doctors and hospitals will have to work together to figure out how to divide up Medicare payments.
Some of the more controversial elements of reform like the requirement that everyone have insurance, new taxes on Medicare for the wealthy, or taxes on companies that make medical devices, will also be phased in. It will be at least 2014 before everything is in place. It is impossible to predict how the slow pace of reform will affect opinions about health reform. Will people get frustrated if change doesn't happen quickly enough? Will opposition die down if change doesn't alter the positive elements of the health care system? Can hysterical threats of disaster maintain their intensity when there's not much disaster to identify? At the very least, we can get back to the business of trying to stay healthy without constantly hearing about health reform every day. And those of us who work in health care can get back to the business of improving the quality of health care in America.