Pushing forward this year is imperative and I commend the efforts to transform the process. However, we must maintain the long term perspective and constrain the roadmap so that our system remains uniquely American. The balance of free enterprise and government involvement, the balance of power between state and local and federal funding of health care, and the preservation of individual rights are at stake as we move ahead over the next 15 years. In addition, we must consider the ethical framework of the treatment decisions as new technologies emerge. Ultimately too much concentration of power may overshadow the patient's rights to direct their own healthcare, leading to interference with the basic freedom of the Constitution.
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