MANAGE WITH CARE

In the minds of many Americans, the campaign for health-care reform ended in 1994, when Congress rejected President Clinton's 1,342-page Health Security bill. Ironically, however, while the Clinton health-care-reform juggernaut was coming to naught, the private sector was revolutionizing health care outright--and it continues to do so. Insurance companies, health-maintenance organizations, private-practice physicians, hospitals, drug companies and a host of other vested interests are all fighting furiously to determine which of these interests comes out on top. When all is said and done, I am afraid, the patient may end up on the bottom.

The biggest surprise in the past two...

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