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Abstract

The critical issue in health policy is the cost of health care, and its importance will only rise further with the changing demographics of the U.S. population. The last twenty years have seen numerous efforts to control costs, beginning with regulatory mechanisms and later dominated by the market-based approach of managed care. At its peak, managed care led to a historic decrease in the rate of inflation in health care costs. Over the last five years, however, managed care has retreated significantly in favor of consumer-driven health care, in which individual patients are more exposed to the costs of care and thus choose more carefully which services to purchase.

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