This rule will be expanded to cover adults over time. And, we should see the self employed and those who work for small businesses have better and more affordable access to health insurance. That’s the good news.

The bad news is that while the legislation was thought out in some areas, cost control was not one of them. Yes, we’ve come up with some ways to help pay for things, including taxing investment income, a tanning tax, and hitting those in higher income brackets harder, but we’ve done next to nothing to enforce costs control.

In fact, many of the provisions in the healthcare bill that are good for us can only be expected to drive costs up. When we’re all insured, we should hopefully see some costs, specifically those associated with the uninsured going to emergency rooms for things they should have seen a regular doctor for years ago, go down as people seek early and more preventative care. However, all that early detection and preventative care comes with a price. Specifically that price is the cost of many more people seeking tests and treatment. It’s good; but it’s expensive and we’ve put nothing in the bill to ensure that hospitals and doctors don’t increase prices as demand goes up.

And, what about malpractice? One of the reasons that healthcare is so costly in this country in the first place is the exorbitant fees that doctors must pay to keep themselves insured against malpractice. When more people are getting treatment, more will sue, so malpractice costs will continue to rise. This is an issue that wasn’t even addressed in the bill.

Finally, it’s almost certain that those of us who were covered by our employers before health care reform are going to see our costs increase. We’ve already been paying through the nose to cover the uninsured; now we’re going to pay through the nose for their insurance.

Many large employers already know that the healthcare bill is going to increase their costs, at least for the short term, so many are already making arrangements to increase their employees’ co-pays, spouse surcharges and deductibles for the 2011 benefits year. We’re also going to see costs go up for those who don’t “follow the plan”. For example, in the future, employer coverage will be different for employees who smoke, who don’t participate in company wellness programs or who are overweight.

Congress got a few things right with this bill. Hopefully, people won’t have to die or go bankrupt because they don’t have insurance. That was an important piece of the legislation, and only time will tell if it was accomplished. But, don’t let anybody tell you that it’s going to cost less over time – it’s simply not true.

P. Zerkle blogs about how to find a program for a Master of Health Informatics.

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