The sound of thundering hoofs in the distance

That's the implementation of the Affordable Care Act next year. The Commonwealth Fund's annual survey of health insurance coverage has just come out, and it's obviously not like former versions because it must talk about the future as well as the recent past (2012). The Affordable Care Act -- Obamacare, if you will, although it might be more accurate to call it CongressCare since the prez was notably passive during the whole sausage factory episode -- has already reduced the proportion of young adults 19 to 25 who were uninsured at some point during the year from 48% to 41%. That's 1.6 million people who have insurance who wouldn't otherwise.

Otherwise, we've been stuck in neutral, with almost half of all adults under age 65 either uninsured at some point, or underinsured, i.e. their out of pocket costs were so high that they couldn't afford them. Which, no surprise, means they are likely not to be buying needed medications:

Note that if you don't take the pills referenced in the chart, such as for hypertension or diabetes, you are likely to get sicker, and incur even higher medical costs. This is rationing. This is death panels.

Next year, the number of uninsured people will fall. Yes, it's likely that the cost of insurance will go up for more affluent people who aren't eligible for subsidies, because all of these sick people will now be in the pool. I say, tough shit. You can afford it, and it's your society too.

There are bound to be all sorts of problems, as there are with any major policy initiative. Normally, once we try it and find out what needs fixing, Congress fixes it. Unfortunately, we have a Republican majority in the House and an obstructive minority in the Senate that wants this to fail. So maybe it will.