Understanding the new vocabulary of healthcare reform.

On March 21, 2010, the United States Congress passed the most comprehensive healthcare reform bill since the formation of Medicare. The legislation’s greatest impact will be to improve access for nearly 50 million Americans who are presently uninsured. Yet the bill does little to tackle the fundamental problems of the payment and delivery systems— problems that have resulted in major quality gaps, large numbers of medical errors, fragmented care, and backbreaking costs. While these tough questions were mostly kicked down the road, the debate did bring many of the key questions and potential solutions into high relief. Our political leaders, pundits, and health policy scholars introduced or popularized a number of terms during the healthcare debates of 2009-2010 (Table 1). I will attempt to place them in context and discuss their implications for future healthcare reform efforts.