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While I enjoyed the newly developed expertise of neurologists in commenting on managed care and potential future, I must suggest to my brothers and sisters in neurology that it appears we are headed for a pluralistic system. Indeed, Wayne Gretsky says, "Go where the puck is going to be, not where it is." Those who think the integrated health care delivery system will be the only system in the future, don't quite have it right. The difference between full choice and limited health maintenance organization is only $600 a year for a family of 4, a well-documented figure that nobody seems to know or care about.
Having gone back to earn a PhD degree in management with a dissertation on social change in American medical care, and as a practicing neurologist, I have opined that we will have a pluralistic, multiple choice, multiple tiered, health care delivery system. One must
Green J. Mismanaged Care. Arch Neurol. 1997;54(3):229. doi:10.1001/archneur.1997.00550150005003