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Now, the hard part

   The passage and signing of the national health care reform bill was, indeed, historic.

   And all the stuff that will have to follow it will be, too.Billsigned

- The debate shifts - Buffalo News Editorial
   The new law provides winners and losers and, more than that, unanswered questions about how the law will be implemented and what it will mean for the national economy, already one-sixth consumed by health care. That's because federal regulators and state lawmakers must now decide how health plans will compete, write rules governing their profit and decide which medical benefits must be provided.
- Politics and policy - another Buffalo News Editorial
   Crushed in the process of producing this bill was President Obama’s promise of bipartisan legislation and public debate. ... Obama is now a “polarizing” president who will find difficulty in getting Republicans to join him in the future.

- Cleveland Plain DealerMarket forces ultimately will have to bend the cost curve and change the delivery of health care. If they don't, then this bill will simply make a bad system bigger -- and that won't meet anyone's definition of reform.
- George F. WillHealth care will not be seriously revisited for at least a generation, so the system’s costliest defect — untaxed employer-provided insurance, which entangles a high-inflation commodity, health care, with the wage system — remains.
- Corpus Christi Caller-Times: The health reform bill is very much a work in progress. Obama said the Tolesmiracle goals of health care reform were near-universal coverage and the containment of costs. But cost controls are the weakest part of the bill.
- Gail Collins: This could go on for some time. Meanwhile, feel free to remind Rush Limbaugh that he promised to move to Costa Rica if health care reform gets implemented. Once you’re done, you can go back and remind him that Costa Rica has national health care.
- Jay Ambrose: This complicated, bureaucratically befuddling act does not begin to address some of the biggest of those problems, almost surely worsens others and much of what it might fix – usually with the probability of massive unintended consequences – could have been done more prudently, effectively and cheaply by other means.
- David Leonhardt: For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.
- Clive Crook: It is right to provide guaranteed health insurance, but wrong to claim this great prize could be had, in effect, for nothing. Broadly based tax increases and fundamental reform to health care delivery will be needed to balance the books. Denying this was a mistake. What was worse--an insult to one's intelligence, really--was to argue as Obama has in the past few days that this reform was, first and foremost, a cost-reducing initiative, and a way to drive down premiums.
- The Chicago Tribune: This legislation has cleaved America, and whatever happens next, the Democrats own it.

Mental health break:

-- George Pyle/The Buffalo News


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