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A Funny Thing Happened on the Way to Reform

Gary L. Tischler, MD; Boris M. Astrachan, MD
Arch Gen Psychiatry. 1996;53(10):959-963. doi:10.1001/archpsyc.1996.01830100109014.
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Out at Free Enterprise, where the Needies fight The Greedies for the great Grail of the World And always lose, we can help balance up The scales of earthly good; not much, but some; And for a wonder, though it hurt at first, It will feel good because our kindness did it.

Howard Nemerov, Trying Conclusions: New and Selected Poems, 1961-1991. Chicago, Ill: The University of Chicago Press; 1991.

TWO YEARS ago, we were eagerly awaiting major changes in the financing, organization, and delivery of health care. But a funny thing happened on the way to reform. America's corporate class discovered that it had the will, the ways, and the means to reshape the health care establishment. They seized the moment and effected a far more dramatic "takeover" than the consolidations and mergers we read about in the business sections of our daily newspapers. The values of the marketplace and


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