Our current national health policy is certainly not the result of a well-conceived, comprehensive approach to health care; rather it is the result of decades of incremental legislation, regulation, and market changes. Put this antiquated legacy system against the backdrop of the worst economic crisis in 80 years, the cost of health care approaching 20 percent of our gross domestic product, health insurance premiums in Colorado approaching 20 percent of median income, and the burning platform for change looks more like a raging inferno. While the national health care reform enacted this week is historic in its proportions, it will by no means be a panacea. The passage of national health care reform legislation, as President Obama, states, “is not radical reform, but it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction.” Over the next few years, there will be tens of thousands of pages of rules and regulations that will interpret the 2,000+ page legislation and spell out more clearly how it will be administered. So it is impossible to determine with certainty today exactly how the legislation will affect us in the future. But against a backdrop of five fundamental issues that must form the basis of a rational national health policy, we can assess how far we have come and how much more there is to do: