The sleek, four-armed "da Vinci" robot has been called a breakthrough technology for procedures like prostate surgery. That's just the kind of impressive-sounding innovation that critics of the healthcare reform act say will be stifled by the new law, with its emphasis on cost control and the comparative effectiveness of new pills and devices. The Affordable Care Act will not reward this kind of innovation. The act will stimulate a panoply of true medical innovations. These may not be flashy; they might not even be visible to patients. But they will improve healthcare and lower costs.