With fewer than 100 days left before the scheduled Oct. 1 launch of federal and state-backed health insurance marketplaces, it's understandable why there's some concern for the hospital community that things may not get off to a good start.

At this stage of the game, a lot is still unknown and a lot could still go wrong. I'm not worried, though, largely because of my experience during the Y2K scare — more on that later.

Research for a story I'm working on about the marketplaces has revealed unease on the subject. A big worry is derived from the fact that nobody knows who is going to sign up for insurance through the state marketplaces. The exchanges need numbers and health. If only a few people sign up or if those that do are much sicker proportionately than the general population, a marketplace could fail. The premiums wouldn't be great enough to support insurers and patient care.

There's plenty that can be done to increase awareness of the marketplaces, given how little is known about them. According to Kaiser Family Foundation poll results unveiled last week, just 20 percent of respondents had heard at least "some" about the marketplaces and 45 percent had heard nothing at all about them.

To help counter that lack of awareness, Health & Human Services department ramped up its consumer enrollment education efforts with the relaunch of its health reform website this week. Hospitals also are working diligently to grow awareness; look for a story on the subject from my colleague Marty Stempniak in July's issue of H&HN.

There's also the question of whether the membership in exchange plans will be healthy enough to support an exchange with reasonable rates and benefits. That problem also is likely to be lessened if enrollment efforts are successful.

On the other side of the equation, there's no guarantee that the marketplaces will be functional when enrollment begins. Major IT projects like this one tend to be completed late or with some functions not yet ready.

At any rate, the reason why I'm not worried about the looming coverage expansion is that stock market investors aren't worried. An interesting story last week noted that equity investors are bidding up shares of for-profit hospitals, which is seen as a good sign for health care reform, especially given that the broader market is not doing great. That interest is underscored by Tenet Healthcare Corp.'s $1.7 billion agreement this week to buy Vanguard Health System.

I'd like to hear from you if you disagree with my conclusions or have other thoughts on the matter. The stock market is not always right, and there is plenty of time for things to go wrong quickly.

I have had one personal triumph using the stock market as a gauge of the future. During the Y2K computer crash scare, doomsayers had me concerned early on that there was going to be bedlam on Jan. 1, 2000, as computers controlling power stations and other vital functions would crash because they couldn't handle a date with "00" for the year.

But closer to the end of 1999, the stock market seemed to be fine with the situation as prices surged. I decided I was, too. While some of my friends and colleagues stocked up on emergency supplies for the transition, I stocked up on sparkling wine. There were no major computer crashes, no mass power outages and no bedlam.

I'm looking forward to learning what the stock market will be telling us about health care reform come August and September.