This week will long be remembered as a momentous time in American health policy and politics.
President Obama signed the landmark health reform legislation and the Senate seems poised to complete the complicated process with passage of a reconciliation bill making a number of changes in the earlier law.
I have long worked for far-reaching overhaul of how we finance and deliver health care in America, and I celebrate this major accomplishment.
We are all hearing several narratives from different quarters ? that predictably conflict:
After decades of trying ? by Democrats and Republicans, far-reaching health reform has passed into law.
This is a major victory for a more compassionate and communitarian society.
President Obama and his party can be proud of their leadership on achieving this.
This legislation gives the federal government a significantly greater role in directing the American health care system.
Republicans will campaign against a government takeover of health care, and they could see major electoral gains this fall and in 2012.
Will it work?
Can we afford it?
Each of us will choose which of those and other narratives to emphasize.
I am very glad it passed, even with its flaws and other consequences that we don't yet know about.
On the whole ? we badly have needed to cover the uninsured ? and this legislation, when implemented, will do that in a big way. The fact that not everyone will be covered is surely true ? but this is a major step in the right direction.
As the head of a major public safety net institution, I am very concerned about the proposed cuts in Medicare. I have to believe, and I do, that these will not occur ? to anything like the extent promised ? because of the predictable push-back of seniors and health providers.
So what that means is this will add hugely to the federal budget deficit ? not a happy prospect, to be sure.
I continue to believe that our nation must press ahead with additional health system reform, that delivers quality care at much lower costs. We can do that ? but it will stretch us like nothing we have ever done before. Just like this process has challenged our political system.
Here at UNC we are dedicated to reform, and we are determined to be a leader ? creating a new model for organizing and delivering care.
So … Health reform has passed … With much more to come! I believe we will be arguing about all of this for months ? indeed for years to come.