The President and CEO of the giant insurer and healthcare managment firm Humana says Obamacare will eventually be good for patients, but 'getting to good' may not be very good.

  "The gross premiums will go up, you will see that in most states," Bruce Broussard told 1200 WOAI news in an interview while he was in San Antonio meeting with Humana employees.

  "I think there are going to be some surprises in pricing, what people buy, what people think they are going to buy."

  But Broussard says the Affordable Care Act will eventually, after we get past the first years bumps, be good for doctors, patients, and the entire health care delivery system.

  "The quality and cost discussion is becoming more apparent with providers, and Humana is doing what it can to try to encourage that," he said.  "I think the consumer is gong to be more important in choosing health care, as opposed to just the employer, which has traditionally been the case."

  He says the country is moving toward a 'results oriented model' when it comes to doctors and hosptials.

  "They are going to be more encouraged, because they are not just going to be paid for the work they do, but for the outcomes of the individual."

  Broussard says Humana has already agreed to participate in 14 states healthcare exchanges, saying most companies plan to 'walk before they can run.'

  So how much will your health care costs be rising?  Broussard says right now, that's hard to say.

  "It really depends on how you look at it," he said.  "Right now it is state to state.  And keep in mind that the subsidies will offset some of that increase, especially for people who cannot afford health care today."

  Broussard says there are some challenges facing insurers in the future, from having to accept all patients regardless of pre existing conditions, to having no lifetime cap on benefits.

  "It is a change in business, but it is one of many larger changes that will probably have an impact, but I don't think this will have a material impact."

  He says more people will be covered by insurance, which will help hold steady and in some cases result in property tax cuts, because taxpayers will no longer be subsidizing the care of people who cannot afford insurance.

  He says we also have to change our attitudes about what insurance is.  He says the purpose of insurance is to protect families against 'catastrophic' health care expenses, and insurance was never meant to pay for every trip to the doctor.

  He says there will be more attention paid to preventative care, so called 'wellness' coverage, because the best way to hold down health care costs is not to get sick to begin with.

  "I think those things will work through the system," he said.  "When I look three or four years into the future, I think there are going to be some very exciting things happening in health care.  I look at the next decade, and I think we are going to make an impact."