By any standard, 2009 was a remarkable journey for those who seek transformational change in the US health care system. The passage of health care legislation through the House of Representatives and Senate represents historic progress toward the goal of an affordable, efficient, and just health care system to meet the 21st-century needs of all Americans. But what began as a pursuit for major health system reform has now become something far less—an effort to pass a more narrowly focused health insurance bill.1 Whether viewed as simply economic common sense or as a moral imperative, expanding health insurance coverage is vitally important, but while necessary, it is by no means sufficient.2
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