Epilogue

Health care reform emerged as a key issue during the 2008 presidential campaign. Following President Obama’s inauguration, the debate was particularly divisive both between and within political parties. Legislation gained and lost momentum, and what finally emerged was largely health insurance reform (in contrast to delivery reform), expanding coverage, revising regulations, establishing insurance exchanges, and setting mandates for businesses and individuals.

A number of smaller pilot projects, focused on the coordination of care and quality, did survive. But the work of “reforming” health care delivery is still ahead. In the months and years to come, we expect to see cuts in Medicare and Medicaid, largely driven by the need to fund ...

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