Universal health care will be the signal achievement of the first Obama administration. Long after the recession is gone and the Iraq and Afghanistan wars are over, all Americans will be able to afford basic health care.
I am confident the net effect will be to reduce health care costs, as we eliminate the overhead costs of preventing some people from getting care, and of forcing other people to use emergency rooms for basic medicine. As we integrate the health care system better, standardizing reporting, records, and electronic information, we should make the whole system much more efficient. Indeed, we should be able to make it a true health care system for the first time.
The health care law as we have it has many problems, most of them inflicted by legislators protecting specific home-state or big-donor industries. The government will improve the law for decades to come. Right now the Republican leadership is making a show of repealing universal health care, but this is more theater than substance. Universal health care is overwhelmingly popular, and they know that it will become more so as Americans come to count on it as much as they do on Social Security and public schools. The act will cost more in the short run, as millions of people are included in regular (not just emergency) health insurance, but the Republicans know it will starting saving money soon - that is why they specifically exempted health care repeal from their requirement that all new bills reduce the deficit.
The United States has the best health care for those who can afford it, but a truly terrible health care system. We have started on the long road to fixing that problem.