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The author comments on the plan of the U.S. Congress to make a decision in the health care reform debate in 2009. He considers the decision as a multidimensional contest that will likely have no clear winner. It notes the relationship between the health care policy and political communities in the country.

The article contemplates on the future of the U.S. health care reform. Highlighting 2011 is the enactment of the Patient Protection and Affordable Care Act (PPACA), which is considered the most controversial domestic accomplishment of U.S. President Barack Obama. 2012, however, is projected to be challenging, particularly with the announcement of the U.S. Supreme Court to hear opposition to the sweeping health care reform law.