In the past two years, the regulation/competition dialogue has polarized into an “either or” debate. The problems facing our health care system are too complex to allow the acceptance of this paradigm. Reasonable people will differ on what they believe are the key factors which contribute to the inflation of health care costs. Four separate scenarios for diagnosing and solving the health care cost inflation problem are presented. Alternative intervention strategies are discussed and the potential of current competition proposals is examined.

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