this is a pretty good rundown:
http://www.cbsnews.com/stories/2010/03/19/politics/main6314410.shtmlthe big change will be the insurance requirements, a la massachusetts - either you're insured (or exempt due to income) or you pay a fine. that's the carrot for the insurance companies, compared with the stick of not being able to exclude coverage based on preexisting conditions. (this particular carrot is why you get folks like michael moore or chomsky speaking against the plan, fwiw)
the other big change is the expansion of medicare benefits to a much larger group of people, including single non-senior adults.
on the hospital side, beyond doctors worried about payouts continuing to shrink and small healthcare clinics worried about mandates to provide comprehensive coverage, there's not going to be that many changes. in theory, less uninsured means less eating of costs at the ER, but that's going to depend on how each state's pool behaves and how many people jump on the medicare train. (medicare is known for being slow to reimburse) in some places, like manhattan, you'll see more doctors who refuse to take any insurance, and negotiate with each patient over costs instead, though probably not a significant amount.
the real issue, as i see it, is that the one thing that continues to drive healthcare costs - the hiding of expenditures from people through employer insurance and the reimbursement cycle that encourages waste from providers and consumers and the shell game that insurance companies now play with approvals - is not going to be addressed. if anything, the idea of healthcare as a right is going to make care denials, deserved or not, even more difficult. at some point in every medical history, of course, care must be denied because free is never really free.*
we got neither a british (worst case) nor french (best case) reform; we got, instead, an extension of the status quo. this will probably set the stage for a single-payer or at least government option system in the next five to ten years, depending on how badly things go and what expectations were going into it.
* as you see from the now release about pricing based on age. imagine complaints about car insurance companies charging people with ten accidents on their record higher premiums as those with none. does that even begin to make a lick of sense?
