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Obama-docLike it or not, President Barack Obama and House Speaker Nancy Pelosi have managed to pass a comprehensive health insurance reform bill, against long odds. The big question is, what happens now?

The vast majority in the insurance business don’t like this legislation, and understandably so, since it focuses practically all of its attention on the industry, without reforming the way health care is delivered.

It also fails to offer medical malpractice insurance relief, guaranteeing that defensive medicine will continue to be practiced, driving up costs through the ordering of questionable tests. Meanwhile, the penalties for not buying mandated coverage is way too small to coax everyone into the system.

But these shortcomings can be repaired, and there is still plenty of time to make fixes–as many parts don’t go into effect for a few years. But this is only feasible if the Republicans engage the Democrats in a proactive way in good faith, rather than cutting off their nose to spite their face.

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