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What now on health care reform

The headline - "Public Option Support Surging in Senate" - sounded so last fall. But there it was last week on Huffington Post, detailing an effort by some Democrats in the U.S. Senate to revive the public option which seemed to be, er, DOA.

So where is health care reform headed? Was the Senate plan a good bill? Did the reform package actually achieve cost savings? Was the debate about the public option worth all of the emotional tumult? These are some of the questions I posed to Alan Garber, MD, PhD, a professor of medicine and director of the Center for Health Policy at Stanford, in my latest 1:2:1 podcast.

For me, two things stood out from our conversation. First, Garber pointed out that health care reform is so complex that it's not easy to break off one part that sells well like health insurance reform and not keep something controversial - like a mandate that everyone buy insurance. It's all part of a larger puzzle. Second, if major reform fails all is not lost. There's another door in through entitlement reforms in Social Security and Medicare.

Clearly, there's still a good chance that the U.S. Senate will move on significant reform. If the Democrats have zip to take to their constituencies, how will they get them fired up for the fall midterm elections? Even departing U.S. Senator Evan "the system is broken" Bayh says he's open to the parliamentary procedure of reconciliation to pass a reform package.

Garber has thought long and hard about health care reform. So it was heartening to hear him declare that while the Senate bill was flawed, it had a lot of important elements that would put a significant stake in the ground.

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