After more than a year of sweating blood, Barack Obama and his Democratic colleagues on Capitol Hill have emerged victorious with the enactment of the most significant piece of US domestic social reform in more than 40 years.  No major entitlement program has become law in such partisan fashion.  In 1935, more than half of the minority Republicans in Congress joined Democrats to create Social Security.And, in 1965, nearly half of the minority Republicans joined Democrats to launch Medicare. This legislation has polarized Congress, and whatever happens next, the Democrats own it.

Now American consumers and corporate executives are trying to determine what the overhaul will mean for them. 

The uninsured are clearly the biggest beneficiaries, with the new law providing coverage to 32 million Americans who have been shut out of the market; either due to pre-existing conditions or inability to pay large premiums. For those already covered by a large employer, there will be less immediate impact.

Medicaid would be expanded.A network of state market places to promote insurance competition would be established. These exchanges are designed to help contain costs by offering individuals and small companies an array of private policies and rates comparable to large group coverage. And, regulations would be imposed on insurance companies to prohibit them from denying coverage.

Affluent families will undoubtedly pay more taxes. Any surprise? The Congressional Budget Office estimates that Washington will spend $1 trillion more on health care in the next ten years, and with what seems to be "fuzzy math" concludes that this bill will ultimately cut the deficit by $138 billion. To the contrary, some predict this legislation will, in fact, not reduce the deficit, but increase it by over $500 billion in the next decade. Under the legislation, about 19 million lower-earning Americas would get tax credits to offset the cost of buying insurance. A further 16 million people would get insurance through an expansion of federal-state Medicaid.

Accordingly, the health care industry will receive 32 million new customers.Hospitals and drug makers, which supported the final bill, would be clear beneficiaries. In addition, the legislation did not create a government-run public option; something that private insurers feared the most.

Even so, private insurers, lead by their main trade group, America's Health Insurance Plans, vehemently opposed the legislation. They are concerned that young and healthy people will not enroll because the new requirements will make their premiums higher to help subsidize the older and the sicker. However, most of the provisions impacting the health insurers do not kick in until 2014.

Just as Social Security grew from a modest start in 1935 to become bedrock of the nation's retirement system, this is a start on health care reform, not the end. Our hope and belief is that this reform will, in the end, accomplish its objectives and start to bring about the change the majority of Americans supported in the 2008 Elections.  Next, let's reform Wall Street and the banking sector.