The day after

What I said before is still true: this is not a game.  No gloating.  No taunting.  We do not strut.

On a personal note, the last time health care reform was in its final state, I was interviewing for medical school.  Every single place I interviewed asked me for my thoughts.  I would try and feel out the interviewer for what they wanted to hear and then regurgitate talking points to match.  It seemed to work great.  Some people wanted to hear how it was socialism.  Some wanted to hear how it was completely necessary.  I remember clearly that at Yale they wanted to hear good things (maybe they felt ownership for Hillary, who went to school there).

What stunned me, though, was that sticking to talking points was more than sufficient to impress the interviewers.  These were high level academics at pretty impressive schools.

This time around, I hope my discussions took place at a higher level; I hope I had something more to contribute.

On a public note, this is a pretty remarkable achievement.  It’s not the bill I would have written, but it’s still a step in the right direction.  For all my griping, I think I owe begrudging respect to President Obama, Speaker Pelosi, and Senator Reid.  There were plenty of times to bail, including the August town halls, the slogs through committee, and the Massachusetts election in January.  But they didn’t, they held strong even when opponents of reform declared it dead.

There’s still work to do with the reconciliation bill.  We will have some signing ceremonies.  And some will celebrate.

But there will still be more work to do.  Even if this bill works perfectly, it’s still not universal.  Unacceptable.  It may help to contain costs, but it won’t be enough.  And we will need to address the maddening way our system doesn’t seem designed to optimize quality.  We need to do better.  We have to.  So no resting.

There’s still malpractice reform.  Pharmaceutical reform.  Delivery reform.  IT improvements.  Cost discrepancies.  Comparative effectiveness research.  And much, much more.

So don’t go away.  Keep coming back.  We’ll still be going strong here.

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