How Large Employers Are Shaping the Health Care Marketplace

Abstract
During the past 15 years, the U.S. health care system has undergone breathtaking changes. It is no exaggeration to call this process a revolution. Authority was wrested from physicians and hospitals and conferred on health maintenance organizations (HMOs) and other managed-care insurers. The revolutionaries are not the downtrodden — low-income and disabled patients or underpaid hospital and nursing home workers. The revolutionaries are America's multibillion-dollar Fortune 500 companies. They set off the insurrection in the 1980s by inducing or requiring their employees to obtain health insurance from managed-care insurers, especially HMOs. Whether employers will allow power to remain in the . . .
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