Health care reform will enable millions more Americans to have health insurance. It will prevent companies from refusing to ensure the sick or limiting the care of costly clients.

        But it also is likely to increase insurance premiums. It may require cuts in benefits to people on Medicare. And it won’t bring insurance to everyone.

       “This is a massive change in a very practical way,” said Robert Brooks, MD, MA, MBA, MPH, associate vice president for health leadership and professor of infectious disease and public health.

Dr. Robert Brooks

        Dr. Brooks provided an overview of what health care reform will – and won’t – do at a seminar Thursday entitled, “Health Policy and the New Healthcare Law: Myths and the Impact on Underserved Populations.”

        The seminar was part of USF’s series of Diversity Learning Lunches and drew an audience of close to 100 students and faculty members.

        Today, 50 million people have no health insurance in a nation that spent $2.5 trillion on health care last year – the equivalent of $8,000 per person per year, or 17.3 percent of GDP, said Dr. Brooks.

       “We’re the best disease care nation in the world,” Dr. Brooks said. “Unfortunately, we’ve sacrificed resources needed to set up the best health care system.”

       The U.S. has focused on acute care, often for people near the end of their lives, rather than providing basic care for all, Dr. Brooks pointed out.

       “Thirty to 50 percent of all health care costs are spent on treatment of preventable diseases,” Dr. Brooks said. “But only 3 to 5 percent of all health care dollars are spent on true prevention programs.”

       Meanwhile, spending on Medicare and Medicaid are rapidly escalating. In Florida this year, Medicaid will cost $20 billion – 30 percent of the state’s budget.

       There are broad disparities in the distribution of who has health insurance: only 11 percent of non-Hispanic whites lack coverage, while 22 percent of non-Hispanic blacks and 33 percent of Hispanics go uncovered.

       How many of those problems will health care reform fix? Dr. Brooks pointed out that the focus is on insurance.

        “It really should have been labeled a health insurance reform bill,” rather than health care reform, he said.

        Dr. Brooks said he would have liked to see a greater focus, for instance, on preventive care. Still, the new law will provide an estimated 32 million more people with insurance.

       With some exceptions, the law requires people to have insurance. Those who don’t will face a tax penalty. Lower-income families will be eligible for credits to help buy health insurance. Large employers will have to offer insurance,  and midsize ones will face a penalty if they don’t.

       Still, Dr. Brooks remains concerned that some families will be left out.

       “It doesn’t mean we’re going to have solved the gap in care for people who are underserved,” he said.

       – Story by Lisa Greene, photos by Eric Younghans, USF Health Communications