It is becoming clear that the U.S. is going to have some form of health care reform this year. Equally clear is the inevitability that this reform package will be lacking in some important aspects. What we're left with might be considered one of those "half empty, half full" sorts of questions.
On some points anything might be considered an improvement over what we currently have. There is near unanimity on the need to cover those without insurance, for instance. That would be a decided improvement. The greatest need right now in this country is the need to provide for those people without the ability to pay for health care. That is job #1, and it looks like we're going to get there.
Unfortunately the packages making their way through Congress are protecting the insurance industry, not the people needing better care at lower costs. So what we might very well have at the end of the day could be similar to what we now have—plus coverage for 47 more million people—at an exorbitantly greater cost. It will be like the insurance in Canada, or England, or France (or Spain, or Italy, or Germany, or Japan) but instead of paying merely double what they pay we'll get off paying quadruple. But rest easy, your insurance company will be safe and secure in profit-making heaven.