If the ACO were the only example of an
undocumented and poorly defined health care “reform” that was flogged
from obscurity to fame by a few well-placed health policy entrepreneurs,
we might dismiss the problems created by the flabby definition of the
ACO as an aberration. But the ACO is not the only example of such
“reforms.”
To the contrary, the ACO illustrates the
norm, not the exception. It is an excellent illustration of how health
policy has been made in America since the modern health care reform
debate began circa 1970. Over the last half-century, every managed care
“reform” that was eventually unleashed on all or large portions of the
American populace followed the trajectory of the ACO
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