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Editor's blog Wednesday 1 July 2009: Obama's health reform chances get a comic boost

God, it's late. Or early. And just a bit hot.

But it's important to see that President Obama is now likely to have the 60 senate seats he needs to avoid Republican filibustering throttling his reforms.

Elsewhere on HPI, you should read the latest instalment of Maynard Doctrine, in which the good Professor looks at the choices facing a putative incoming Conservative administration.

Elsewhere online, Pulse has the whole of Hamish Meldrum's BMA conference speech. His section on reform is interestingly nuanced: "there are things that we can do to improve the quality of care for our patients and to try to reduce increases in demand. First, we need to vastly improve the outcomes’ data for the services we provide. What drives quality in clinicians is knowing that they are doing a good job – even that they’re doing it better than their colleagues!

"Second, we must look seriously at the issue of service redesign to provide care more efficiently. I know that will worry some of you and that you will think we are dancing to the government’s tune. No way! I’m talking about difficult decisions but ones that are made for evidence-based, clinical reasons not purely for political or financial expediency.

"Third, we need to put a much greater emphasis on lifestyle services to reduce morbidity and hence need. Fourth, it’s imperative that we adopt a healthy ageing strategy to reduce the dependency of the elderly population and narrow the gap between healthy life expectancy and overall life expectancy.

"Just as with tackling climate change, we need a whole-system and across-government approach to improve the health of the public, with every citizen involved from the prime minister, downwards – or upwards, depending on your point of view! Only that way will we slow the inexorable rise in pressure on our National Illness Service and cope with the financial and clinical challenges that lie ahead.

"Of course, none of these alone will solve the problems for the NHS and we must look at how we can use scarce resources more efficiently, where we can cut out waste and unnecessary expense".

Tomorrow I will get stuck into the steaming crock of shit that is the recent announcements on health "entitlements". For now, suffice to say that you can really tell when a government made up of too many lawyers runs out of steam.