"East meets West"

For most of the 70s and 80s, the East was considered to be the center of hospital rate regulation and the West the center for free-market competition. Managed care in the East was "home grown" and large, national public companies generally stayed away from these markets. But, in a fascinating shift amid a great deal of turbulence, the East is starting to look at lot like the West. Economics are driving reforms and the best move for lawmakers is to stay out of the way. The train has already left the station. Perhaps the most frightening thing about the most recent Group Health Association data is that the President comes from a state with less than 3% HMO penetration. Many of his trusted advisors come from that state, including physicians who report on the home front.