Abstract
The two recent descriptions in the Journal of the health-care cost-control systems in Massachusetts1 and California2 support the observation that the country is being pulled in two opposite directions at once, as frantic efforts are made to control ever-rising health-care expenditures.The two states have long presented sharp contrasts in the organization and sponsorship of their health services and in their patterns of medical practice. Now they are taking different approaches to the problem of controlling health-care expenses.The contrast in the two approaches could hardly be more extreme, as evidenced by the two Journal descriptions. The California approach incorporates . . .

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