The costs of healthcare reform being pushed through Congress by Democrats will be felt long before the benefits. Proposed taxes and fees on upper-income earners, insurers, even tanning parlors, take effect quickly. So would Medicare cuts. Benefits, such as subsidies for lower middle-income households, consumer protections for all, and eliminating the prescription coverage gap for seniors, come gradually. Most of the 30 million uninsured helped by the bill won't get coverage until 2013 at the earliest, well after the next presidential election. More than two-thirds of Americans get their coverage through large employer plans and their premiums won't go up because of the legislation, according to number crunchers at the nonpartisan Congressional Budget Office. But Congress can't abolish medical inflation, so don't expect premiums to drop. For people who buy their own insurance policies, about one of every six Americans, premiums will go up. But that's for better benefits prescribed under the legislation. And about half of them would get tax credits to substantially lower their costs.