Some of the key changes will include the rollout of state health "exchanges", the enforcement of the individual mandate, and the shift towards "bundled payments" for doctors and hospitals. The potential Medicare cuts under budget "sequestration" could also be an enormous issue.
Prices will continue to rise and access to actual care will decline in an already overcrowded system.
Biotech companies and drug companies may feel that the climate is no longer ripe for innovation.
Hospitals and other health care providers will continue to struggle amid shrinking reimbursements.
Bottom line: my patients who gain a new insurance card may find that it doesn't buy them the care they were expecting.
I also anticipate some critical flashpoints will be Health Savings Accounts (HSAs), concierge physicians "opting out" of the system, and the scope of "practice guidelines" for physicians remaining in the system.