By Evan Falchuk

Here are eleven things that are absolutely going to happen** in 2011.

They are in no particular order….or are they?

1.  There will be no big compromise between President Obama and the Republicans on health care reform. Why?  Because the law is such a massive collection of, well, stuff, that it is pretty much impossible to find pieces of it that you could cut a deal on, even if you wanted to.  And no, the federal district court decision on the individual mandate doesn’t change my mind…and in fact may breathe new life into other parts of the law).  State governments, insurance companies and private businesses have made all kinds of important and hard to reverse choices based on the law as is.  There’s not much of an appetite outside of people trying to score political points for making big changes.

2. No major employer will drop their health benefits. No major employer is going to outsource their health care benefits to the government any time soon.  Employers- particularly the big self-insured employers that pay for health care costs as a bottom-line expense – see their benefits as an integral part of their business and competitive strategies.  As Congress looks at this issue more closely, they will learn this.

3. Time that doctors spend with patients will be less in 2011 than earlier years. It’s a long-term trend, and the factors that create this problem aren’t getting better.  The latest government data show that the average doctor visit features face to face time with the patient of 15 minutes or less.  With an aging population, increasing numbers of people getting health insurance, and no influx of new doctors, this problem will keep getting worse.

4. Misdiagnosis will emerge as the hot new topic in health care quality. More and more attention is being paid to the root causes of health care quality failures.  People will increasingly look to the ground-breaking work being done by doctors like Patrick Crosskerry and others.  Start out with the wrong diagnosis and you’re headed down a very perilous path.

5. More employers will start charging employees surcharges for being overweight, smoking, or otherwise not taking care of themselves. Among self-insured employers, who pay for a huge proportion of American health care costs, this is becoming increasingly mainstream.  These employers are saying to their employees:  it’s your business if you don’t take good care of yourself, but it’s mine to pay for the consequences of it.  So, employees are being told they need to pay extra for their health coverage, unless they participate in programs the employer makes available to help them quit smoking, lose weight and manage their chronic illnesses.

6. The health insurance system will start to take on more and more of the bad aspects of the workers compensation system. If you get hurt at work, you end up in an often strange parallel health care system, where lawyers and rules and regulations may seem as important to your care as medicine.  Some say that aspects of health care reform will bring that same dynamic to regular health care, and I think they have a point.  If health care policymakers were more aware of how our workers compensation system works, they’d implement more of it.  Look for that to start to happen.

7. A doctor will get sued by offering medical advice to a patient online. It’s America, so it’s bound to happen.  When it does, it will make for a great media story.

8. Google or Microsoft will emerge as the leading standard for electronic medical records. One of the biggest problems with getting electronic medical records (EMRs) implemented is that there isn’t any agreed-upon standard.  Who has a better chance of creating an industry standard?  A clever health care IT company, or a massive company in the business of creating industry standards for IT?  I’m betting on the big boys.

9. State governments will start major redesigns of their health care benefits programs. States are spending enormous amounts of money on benefits packages that are far richer than anything in the private sector.  There’s a tremendous amount of money to be saved for state governments by modernizing their benefits programs.  Look for this to start to happen in 2011.

10. “ACO” will be the hot buzzword in health care. If you don’t know what an ACO is, you will.  Parts of the reform law encourage providers to set up these entities, which are something like HMOs, version 2.0.  Creating an ACO requires a lot of changes to the way  providers operate.  We’ll see if they end up being successful, but they will be a hot topic.

11. Health care reform will become more popular in the polls. It can only go up.

We will check back at the end of 2011 to see how I did.

** By “absolutely going to happen” I mean, “unless I’m wrong.”