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Health reform phase one

Thursday was a good day for children with pre-existing health conditions, for sick people approaching lifetime limits on insurance benefits and for children under age 26 dropped from their parents' insurance policies.

They all benefited from the new health-care reform law, whose first provisions curtail the most mercenary practices of insurance companies. The law also requires them to provide preventive procedures, such as colonoscopies, mammograms and immunizations, without co-payments.

The law is a historic achievement, which eluded presidents since Harry Truman. Yet it remains controversial because of unease over revamping such a large segment of the nation's economy without bipartisan support.

Republicans were -- still are -- adamant in opposition, even though many of the bill's provisions mirrored ideas their party leaders had propounded years earlier. The legislative wrangling left a sour taste and many Democrats who supported reform out of principle or party loyalty have since distanced themselves from it.

Ceding the debate to the critics, though, obscures the reality that the status quo was unsustainable. American health care is excellent for those who can afford it, but even they are at the mercy of insurance companies. Millions lack insurance, which means they skimp on preventive care and when seriously ill or injured go to hospital emergency rooms, the most expensive place for treatment. Hospitals provide charity care but then pass some of those costs to people with insurance, the "cost shifting" the supposedly odious individual insurance mandate aims to end.

The criticism also ignores projections from the nonpartisan Congressional Budget Office that the law will reduce the deficit by $143 billion over 10 years.

Its full impact won't be felt for years unless Republicans succeed in their pledge to repeal it. But the Obama administration is striving to put the new template in place and the insurance industry is adapting, which makes unraveling this monumental reform less likely.


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