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In the early 1990s, I began my health care career as a group insurance underwriter. Shortly thereafter, the Clinton administration called for an overhaul of the private system and a move to a government sponsored program. The industry responded with a relentless assault led by pharma, insurers and conservatives against big government.

With the reform’s demise, we witnessed the expansion and development of managed care, consumerism, chronic condition management, centers of excellence (catastrophic cases, e.g. cancers), wellness and a host of quality and outcome evaluators. The attention would be shifted from industry waste, discriminatory pricing practices, windfall profits, consolidation and variant clinical quality to the patient and his/her lifestyle, decision making, under-education, addiction and insatiable appetite for pharmaceuticals. A collective industry sigh ensued.

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