Healthcare Reform Passed. Now what?

Sunday night was a watershed event for healthcare.  For over a year, the hotly contested subject of healthcare came to a final vote.  We are now left with sorting out what the actual bill will mean to individuals, employers and insurance companies. 

Some of the specific details of the law are starting to come out.  For some, this bill brings hope, security and a brighter future.  For others, this bill represents another unfunded entitlement program that will continue to send the American economy down the road of economic disaster.  Whatever side you represent, a few things are certain to happen:

1. Costs will continue to go up - No matter what bill was passed, costs will continue to go up. As Dr. Delos Cosgrove, CEO of the Cleveland Clinic recently said in the March 1, 2010 FORTUNE issue, "There's a dirty little secret and I might as well tell you to start with. The secret is that regardless of what happens with health-care reform legislation, the costs are going to go up. We have more elderly people, and we can do more for them. So regardless of what happens, we can really only try to contain the rate of inflation. The cost is going to go up over time." Let's make no mistake, just because this bill or any bill that was being debated is passed, it does not decrease the cost curve. It "may" slow it (that has yet to be determined. We will see) but the curve will continue to go up.
2. History is a great indicator of the future - Whenever a piece of legislation is passed in Washington or at a state level, it is difficult to almost impossible to quickly correct problems with the legislation. Some would argue the recent healthcare bill passed can be viewed as an entitlement. With that said, lets fast forward two to five years. If we find we can't effectively cover the additional population either due to costs, access or other means, how are we going to put this in reverse? History shows once program put in place it is difficult for our representatives to "cut" or eliminate programs. It is political suicide. We have seen this with Medicare cuts and other programs.
3. Access to primary care will be stretched even further - One of the reasons our healthcare cost curve has grown quickly is those without insurance utilizing the emergency room as the primary care provider. As we all know this is the most expensive care one can receive. Adding the 30 or so million people into the insurance market one has to ask the questions:

a. How fast will those who have used the ER for care move to a primary care provider relationship?

b. Currently, we are already stretched for quality primary care providers. How will an already stretched primary care system be able to handle another 30 million people?

Some statistics show less than 5% of today's medical students are going into primary care.  In a recent article that appeared in National Review (online) by Michael Tanner from the CATO Institute, he shared that In Massachusetts, after the passage of Romneycare, the wait to see a primary-care physician increased from 33 to 52 days.

We all know the healthcare system is in need of an overhaul.  We will see if this particular overhaul was the right one.  For our children and grandchildren's sake, let's hope so.  However, hope is not a strategy.