The bills have been watered down with compromises so much that much of the real reform the President wanted has been lost.  However, there is some substantial insurance reform: Extending coverage to millions of uninsured; restrictions on denying coverage; etc.

Perhaps the more important reforms longer term are the efforts in the Senate bill to control costs with provisions like pilot programs and bundled payments, and authorising the HHS secretary to implement reforms that will reduce costs longer term (without requiring legislation).  One major piece of cost control missing in the legislation is malpractice reform.  I believe the Republicans missed a golden opportunity for serious reform of medical malpractice.  A single Republican senator willing to back the plan if it included malpractice reform would have marginalized Joe Lieberman and Ben Nelson, and delivered a much stronger bill.

The view from down under is that the US health care system has committed itself to continue to be the world’s most expensive health care system, but the Senate attempts to ‘bend the curve’ are admirable.