As 2007 came to a close, many of the themes of the year had yet to play themselves out.
One of the biggest shifts was the return of healthcare reform as a national political issue.
Every presidential candidate of both parties was forced to address the question, but as usual, nothing much actually got accomplished. Despite the Democrats takeover of Congress early in the year, they were unable to achieve even modest goals, such as an expansion of the State Childrens Health Insurance Program.
Serious health system overhaul appeared at year-end to be a topic for 2008 campaign speeches and action in 2009 at the earliest.
Decisions on major policies affecting healthcare were pushed to the last minute as Congress and the White House wrangled over budget legislation. Lawmakers in December passed a bill that reverses a scheduled physicians pay cut and extended SCHIP.
On other fronts, the news also was unresolved. Hospitals maintained healthy margins but still faced uncompensated-care problems. Quality efforts mounted, but standards were still all over the map. Mergers led to changes in ownership but not necessarily in operation.
And so it may take months or even years to determine the real impact of 2007 on healthcare.