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Since 1980, the author has examined the theme of competition in the delivery of health care services from both its conceptual and empiric aspects. He concluded that federal legislation to introduce a higher degree of competition into the delivery of health care was unlikely to gain congressional approval, but that even if it did it would fail in its central objective of slowing the advance of health care costs. Given these assumptions, he turned to a consideration of the major trends and transformations during the last 30 years and then addressed the critical questions of what lies ahead.
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