By Bernadine Healy, M.D.

People under age 36 form the dominant component of America's 45 million uninsured. Among them, the ages most lacking in health insurance are those in their 20s. You and I know them: They are just out of school, in entry-level or part-time jobs, or between jobs. They are usually blessed with good health, however much they may take it for granted. And they are relatively inexpensive healthwise, compared with those over 60 (by a factor of five or more), because they are spared age-related chronic diseases that consume most of the healthcare dollar, like atherosclerosis clogging arteries of the heart and other organs, degenerating bones and brains, and the vast majority of cancers. Young people have less expensive needs: preventive and primary care and assurance that they will be covered if they do encounter that infrequent, costly, unexpected catastrophic health event.

By Bernadine Healy, M.D.

President Obama has been making a hard sell on getting public opinion and Congress behind his vision to overhaul the nation's health system. Last night, the president's prime-time news conference focused almost solely on the issue. Here are a few obstacles that Obama needs to overcome:

By Bernadine Healy, M.D.

President Obama was caught off guard recently when asked how he would react if Malia, Sasha, or Michelle needed medical care not covered by the public health insurance plan he favors. It was a telling and awkward moment; he paused, then indicated he'd seek out whatever care he felt was best for his family. He recalled his grandmother's hip fracture and facing the question of whether surgery would be appropriate for an elderly woman ill with a serious cancer. Pinning or replacing a shattered hip restores mobility and relieves unbearable pain. His response—to get her hip surgery even if it meant paying out of his own pocket—was deeply personal, neither blue nor red.

[Watch the video: Dr. Healy on Challenges Ahead]

By Bernadine Healy, M.D.

When I was director of the National Institutes of Health in the early 1990s, little did I know the man I was struggling mightily to recruit to NIH would, almost two decades later, become NIH director himself. It's not that Francis Collins wasn't director material even then. It was that I was too focused on bringing him on to be the first permanent head of what was one of NIH's most important scientific efforts of the 20th century: the Human Genome Project.

It was clear through all our negotiations that Francis was an original. Devoutly religious, motorcycle riding, and boyish faced, with a haystack of blondish hair and a devilish sense of humor, he was also one of the most prominent physician-scientists on the planet, having just recently identified the first gene to be linked to cystic fibrosis. Competitive, yes. Driven, of course. And also, just plain nice.

By Bernadine Healy, M.D.

Doctors want to be healers and not bean counters, President Obama observed, warming up a skeptical American Medical Association assembly gathered to hear his plans to reform healthcare last Monday afternoon. The president sought the doctors' support. They proved to be a polite and kindly audience, riveted for almost an hour. I counted close to 50 rounds of applause, much laughter, and only one round of boos.

To encourage the country's physicians to join his journey, Obama in his gracious way delivered some strong and scary talk. If comprehensive health reform is not passed, he warned, the financial health of the nation—not just our medical system—will require life support: "If we do not fix our healthcare system, America may go the way of GM: paying more, getting less, and going broke."

Doctors' overtreatment of patients was one of his big themes. All doctors have seen it, he said. And he's right. It can occasionally be a nasty way to juice up income, which is categorically unethical. But this is by no means the predominant explanation for overtreatment, which some have calculated as accounting for 20 to 30 cents of every health dollar.

By Bernadine Healy, M.D.

Change is coming to medical care in America, and it may be a done deal by summer's end. From Capitol Hill to the White House, enthusiasm is running high for President Obama's plan to morph with lightning speed the current patchwork, private-public blend of healthcare into something closer to a single-payer, government-run system. Steadfastly promising to bring high-quality, affordable care to everyone, the president assures people that they will keep their own doctor and insurance if they want, see a return of some $2,500 to their pocketbook, and become decidedly healthier. But restructuring will inevitably call for sacrifice on the part of most individuals. Today, Sen. Ted Kennedy introduced a 600-plus-page bill, the first of several bills that will be issued in a flourish in the next few weeks. Since full details of what might make it into the final legislation won't be known until later this month at the earliest, barely a month is left for any kind of public discussion before a July vote. Enough common threads have emerged, however, to indicate that people should start looking beyond the headlines now for an idea of how the new system will affect them personally. For starters, here are seven ways that your healthcare experience is apt to change:

By Bernadine Healy, M.D.

One thing that's clear from the political winds blowing at both ends of Pennsylvania Avenue is that the perceived secret to getting health reform done is to keep the details away from pesky critics until it's almost too late to say no. On this, President Obama and a select group in Congress have emerged as a phenomenal tag team. Obama is the frontman, speaking in great generalities and making pledges that are almost too good to be true, while those in Congress, emboldened by a nearly filibuster-proof Democratic majority, are at work behind closed doors on the nuts and bolts. The promise is that all Americans will soon be guaranteed affordable, high-quality healthcare and the freedom to choose whatever doctor or health plan they want, all at a savings of some $2,500 per family. This comes with an even broader assurance: the very salvation of our economy, which Obama preaches is doomed without the cost-tightening of health reform. But slow down here. We need to look critically at this sales pitch, because reform comes with a price that is only gradually being revealed.

At the moment, committees in the House and Senate are penning their sweeping legislation on a timetable that will not allow for a public viewing before mid-June. Passage is expected in July, in time for a presidential-congressional victory lap by summer's end. The reason for this breathtaking pace? A big one is the fear that if it doesn't happen fast, it won't happen—and that many of those who lived through the Clinton health plan debacle in 1994 believe that the devil in the revealed details of that plan sank it.