Health care reform hasn't gone exactly as planned for the president and Democratic leaders. The loss of a filibuster-proof Democratic majority in the Senate brought reform to a halt, at least temporarily. While congressional leaders and the president are attempting to plot a course for reform, the prospects for broadscale reform remain unclear.

The American Hospital Association is watching and waiting, ready to respond, and remains firmly committed to comprehensive, balanced and structured reform that is financed as a shared responsibility across all stakeholders, including hospitals. The AHA continues to be guided by the Health for Life framework, which was created after extensive consultation with members, and its five elements: coverage for all, paid for by all; more affordable and efficient care; the highest quality; the best information; and a wellness and prevention orientation.

The AHA has always maintained that some combination of changes in public policies and hospital-based leadership initiatives is needed to create improvements in care. The Hospitals in Pursuit of Excellence strategic platform ( is one way the AHA is doing its part to achieve that goal. It will continue to support improvements in quality, safety and efficiency by sharing proven practices from across the field, and by leading national collaborative projects such as the effort to gain broadscale adoption of a proven checklist to eliminate central line-associated bloodstream infections. The AHA will also continue to develop and disseminate action guides, such as the most recent one on reducing avoidable readmissions (available at, to help the field tackle the tough issues.

As the AHA continues to engage in the national reform debate, it will keep the field updated on reform developments—and provide members with messages to influence the discussions—through multiple communications channels, including regularly scheduled webcasts.

What's the next step for health reform? No one can say for certain. But rest assured that the AHA will continue to advocate on your behalf and do all that it can to support the work we do for our patients and communities.

Stephen Smart, D.D.S. (, is COG chair and chair of Medical Center of South Arkansas in El Dorado, Ark.