As a new administration takes power in Washington, D.C., backed by a Congress controlled by the same party, the healthcare industry braces for change.
President Barack Obama won the presidency promising, in part, to reform U.S. healthcare. By "reform" he meant increasing access, decreasing cost and improving quality.
A tall order, but one a majority of the American voting public supports and perhaps even expects, given the historic nature of the election and the economic depths to which the nation has sunk.
While Obama's vision for the future of U.S. healthcare remains somewhat murky in these nascent days of his administration, we have some sense of his priorities.
As I write, the House of Representatives has adopted a 4½-year reauthorization of the State Children's Health Insurance Program - a promise Obama made and appears ready to keep.
The House version of SCHIP would cover about 11 million children - an increase of 4 million - and extend the program until Oct. 1, 2013. SCHIP spending would increase by $32.3 billion and be funded with a 61-cent increase in the federal tobacco tax. The bill is similar to the 2007 and 2008 versions that were passed by Congress but vetoed by President Bush.
The Senate Finance Committee voted to send its version of SCHIP reauthorization to the Senate floor, but the bill's differences from the House version indicate some of the problems that could dog broader healthcare reform measures in coming months.
To wit, the House version of SCHIP includes language that would prevent any physician-owned hospital that did not have a Medicare certificate on Jan. 1 from acquiring one.
The Senate version does not have such a ban, but both bills end a five-year waiting period for legal immigrant children and pregnant women to be eligible for Medicaid and SCHIP.
Republicans in both houses of Congress oppose this last measure, and could still scuttle the bill.
SCHIP reauthorization will pass in some form, but the ideological differences highlighted by these battles over the details of a relatively uncontroversial measure are merely precursors to the healthcare wars to come.
Take Obama's proposed $825 billion stimulus package, which includes many billions of dollars for healthcare in various forms.
The $20 billion Obama wants for healthcare information technology has drawn much attention, as the president appears to believe - as many do - that IT is the panacea for all of healthcare's cost and quality ills.
Yet that amount is dwarfed by the $87 billion the administration wants to spend increasing the share of Medicaid costs the federal government reimburses states, and the $30.3 billion that would extend COBRA health insurance coverage to the unemployed, beyond the 18 months provided under current law.
And don't forget the $8.6 billion of federal funding through 2010 for state Medicaid coverage of low-income individuals who are involuntarily unemployed.
While you may detect a note of sarcasm, I do believe that these proposals - and many others in the stimulus package - have merit. But if you think there's disagreement over aspects of SCHIP, just wait until debate begins on the stimulus.
And as for even more extensive reform of the healthcare system? In the words of Rep. James Clyburn (D - S.C.), I just hope the new president doesn't "bite off more than he can chew."