Stephen Shortell in the September 16th issue of JAMA states: "If health care reform is to succeed this year, compromise is greatly needed to reach agreement on how to cover the increased cost of expanding health insurance for all US citizens."

"Taxing alcohol, tobacco, and related products; taxing high-income individuals and families; and capping the tax credit on employer-sponsored insurance and related revenue-generating proposals will, even if enacted, be insufficient to cover the estimated $1 trillion cost of expanded insurance coverage over the next 10 years. ^"

Regardless of the reform efforts, however, he says "it is certain that failure to act now to reform the health insurance and health care delivery system will keep the United States on the path of ever-escalating costs and increasing numbers of uninsured persons, while offering the poorest value for the money invested among nearly all nations in the world."

In other words, the author is auguring for basic, elemental changes in the health care delivery system, extraordinary public health interventions and comparative effectiveness research and feedback….Now!

Stephen M. Shortell, PhD, MPH, MBA (U. Cal., Berkeley)  "Bending the Cost Curve; A Critical Component of Health Care Reform." JAMA. 2009;302(11):1223-1224.