Big decisions will be made in the health care industry in 2011, both on the local and national stage.

Locally, voters will decide the future of Memorial Health System. The City Council is moving ahead with plans for an April ballot issue that will create an independent, nonprofit instead of a municipally owned hospital system.

That’s no small decision, and what the voters decide will have a big effect on health care services in Colorado Springs for years to come.

The hospital’s administration wants to use its new-found freedom — pending voter approval, of course — to expand Memorial’s reach throughout southern Colorado, create new partnerships with physicians and meet the national health insurance reforms of 2010 head-on through electronic health records and other alliances.

Nationally, the courts will consider the many lawsuits about health care reform. So far, a single judge has ruled the individual coverage mandate — requiring people to buy health insurance — is unconstitutional. That ruling is sure to be appealed, and that appeal is almost definitely headed to the U.S. Supreme Court.

But even as legal challenges persist, some provisions will go into effect in 2011:

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Medicare will provide free annual wellness visits and personalized prevention plans. New plans will be required to cover preventive services with no co-pay.

A 50-percent discount will be provided on brand-name drugs for Medicare Advantage or seniors enrolled in the prescription drug plan.

A plan to provide a vehicle for small businesses to offer tax-free benefits will be created. The plan is designed to ease administrative burdens of sponsoring a cafeteria plan.

The Medicare payroll tax increases from 1.45 percent to 2.35 percent for individuals earning more than $200,000 and for married couples filing jointly above $250,000.

Colorado will also put the finishing touches on its plans for health insurance exchanges, as required by law.

Finally, health care insurance premiums will be rising in 2011, following a decade-long pattern of double-digit increases. Moves to lower those costs through prevention and wellness plans will continue to gain steam.