In the article published in the October 1996 issue of the Archives, Dr Bodai1 has presented the myth of managed care in a highly pictorial fashion. Someone who is not familiar with the American Managed Care System will be convinced by Dr Bodai's publication that American Managed Care System is the answer for the high cost of American health care system. One must analyze the presentation of Dr Bodai in a very broad dimension. The Health Maintenance Organization (HMO) and Managed Care of Permanente Medical Group is one of the oldest and largest HMOs in North America. A considerable number of Permanente Medical Groups are affiliated with the teaching hospitals. We must understand that Permanente Medical Groups have their own HMO and Preferred Provider Organization (PPO). They manage their own HMO and PPO. Dr Bodai is teaching residents and is involved in medical research. This is not the blessings