There was isotope coursing through my organs at St. Vincent's Nuclear Heart Center as the health reforms were heading toward President Obama's desk.

I was doing what I was supposed to be doing - preventative medicine.I asked the doctors and nurses shepherding me through the process how they felt about the health reforms. There was great skepticism.The key element - allowing insurance companies to sell across state lines - wasn't in the mix. All the doctors I talked to were concerned about the Medicare/Medicaid reimbursements. One said he might explore just practicing for cash. Dealing with for-profit insurers and now the reduced Medicaid/Medicare is a no-win situation.

Mostly, however, the sentiment was that of the unknown. In the political realm, however, everyone is now an expert. Democrats are quick to defend their votes as if the bill President Obama signed was a panacea for what ills America. Republicans are calling it a "catastrophe" that will literally usurp our freedoms.

Gauging the political realm is like watching one party in the universe and the other in the alternative universe. In something as immense and profound as the new health reforms, there will be elements that will work, others that will need to be tweaked, and others jettisoned.

Kevin Woodhouse, an Ice Miller attorney specializing in health care, agrees with that assessment.

"The ultimate result of all this is going to end up somewhere away from the left and right and somewhere in the middle," Woodhouse said. "Whether it's a good thing depends on your perspective and how you're impacted. The administrative application will be important."

Gov. Daniels has been sounding the alarm over the impact of Medicaid on the state. There are FSSA estimates that it could cost Indiana $2.3 billion as some 750,000 new Medicaid recipients will be added to the rolls. About 66 percent, to be phased out over time, will be off-set by the federal government. The 44-cent cigarette tax that funds the Healthy Indiana Program can be applied to Medicaid.

"That's up in the air," Woodhouse said. "There are federal supplements that pay cost of states for a period of time, but how that plays out over time, all states will have to address. Ultimately, it will increase expenses for states, there's no question."

This gets into a values question. Gov. Daniels sees it from the impact on taxpayers.

"Hoosiers will also face higher state taxes as Medicaid rolls explode," he said. "It will raise by trillions the crushing debt we already are leaving young Americans; any claims to the contrary are worse than mistaken, they are knowingly fraudulent."

But Senate Minority Leader Vi Simpson views it from the social safety net.

"I am disheartened to hear that the governor is discouraged by the prospect of 744,600 uninsured Hoosiers who will now have the opportunity to access health care," Simpson said. "I, however, am optimistic about the future and for the thousands of Hoosiers who will now be able to receive health care."

This part of the issue screams for more data. For years we've watched inner-city medical centers run towering deficits. As magnets in the urban core, they're havens for the uninsured whose lives don't include preventative care. They show up when there's an emergency. Taxpayers and consumers are already paying for that. By adding 744,000 people to the Medicaid rolls, will that just bring the hidden costs taxpayers are already paying out into the clear?

Another problem is capacity. Indiana was facing a doctor/nurse shortage well before anyone even heard of Barack Obama. Since Massachusetts Gov. Mitt Romney passed that state's universal coverage, they're now dealing with capacity issues. John Iglehart, writing in the New England Journal of Medicine, notes: In a recent survey of Massachusetts physicians, those in seven of 18 specialties reported shortages of doctors. Also, 40 percent of family doctors (up from 30 percent in 2007) and 56 percent of internists (up from 49 percent) said they were not accepting new patients. The Massachusetts Medical Society's Dr. Mario Motta explained, "Universal coverage doesn't equate with universal access."

Woodhouse explains, "The other challenge for providers and primary care physicians is whether we have enough time to service 32 million more Americans. There are providers who are burned out already. Do we have enough capacity in the system to service more Americans? That's one of those unknown questions."

Of greater concern is that the American political scene is condemned to see more outrage, propaganda, and divisiveness. There are disturbing hints of violence. The middle range of the spectrum has fallen away after decades of gerrymandered districts that protect all Congressional leaders and push the left and right fringes further outward. Both political parties are responsible for the explosion of debt that could doom the empire in which we squabble today.

The lack of common ground sets the stage of Pyrrhic victories and gridlock.

- Brian Howey publishes online at www.howeypolitics.com.