While there is widespread acknowledgement that the U.S. healthcare system is not economically viable for much longer without some sort of change, there remains little consensus on what healthcare reform should entail. The genuine window of opportunity for massive health system reform has forced public officials and private citizens alike to examine their individual views of healthcare rights and responsibilities in the context of American life. Many have floundered when trying to articulate exactly what it is they want the U.S. health system to look like. In this high stakes contest of idealism versus pragmatism, the easier course is to identify and decry proposals with which one does not agree. The more difficult course, as stakeholder organizations and Congress can attest, is that of envisioning how an optimal system would look and function, building it proposal by proposal, and enacting legislation that embodies the vision.
At press time Congress had offered two proposals, one in the U.S. House of Representatives and one in the Senate. Our cover story reviews these proposals with a focus on aspects of interest to neurosurgeons. In related articles, a neurosurgeon reviews healthcare reform enacted in Massachusetts and proposed in California, and another scales Capitol Hill to make the case for meaningful medical liability reform.