Does America need a "Cadillac" health care system?

From a third-party payor's perspective, productivity in the health field is not a question open to debate, it is a matter of survival. The corporate model of the health care system has disintegrated as competition declined due to a relatively free-flowing financing network. Without competition, productivity has declined. This will set the stage for domination of the health care scene by for-profit chains unless not-for-profits increase productivity. For third-party payors, selective contracting, invented by Blue Cross in 1929, will dominate health care financing in the next century.