My crystal ball only goes so far out. But in the next five or ten years, I'd be quite surprised if Congress passes a plan that produces a very significant positive impact.
The core problem is that any policy that actually improves healthcare will by definition result in far lower healthcare spending. That means lots of doctors, nurses, insurance companies, etc will lose money and jobs. In a Congressional system, determined, concentrated factions will always beat the public as a whole. Very few people will vote out their own Congressman if healthcare reform fails. But if it succeeds, and results in cutting healthcare spending, then many nurses and doctors will switch their vote and stop donating money. Read "Government's End" by Jon Rauch. I interned on Capitol Hill, and his take on the problem is one of the most accurate - http://www.amazon.com/Governments-End-Jon-Rauch/dp/189162049...
The core problem is that any policy that actually improves healthcare will by definition result in far lower healthcare spending. That means lots of doctors, nurses, insurance companies, etc will lose money and jobs. In a Congressional system, determined, concentrated factions will always beat the public as a whole. Very few people will vote out their own Congressman if healthcare reform fails. But if it succeeds, and results in cutting healthcare spending, then many nurses and doctors will switch their vote and stop donating money. Read "Government's End" by Jon Rauch. I interned on Capitol Hill, and his take on the problem is one of the most accurate - http://www.amazon.com/Governments-End-Jon-Rauch/dp/189162049...