Back in 1982, when I first began my career as a family practitioner in a small town of Boston, I was confident that the care I’d provide would be as effective as the care patients receive anywhere in the world. At the time, the death rate for Americans was lower than that of comparable countries, resulting in 128,000 fewer deaths annually. Although healthcare was expensive—costing 2.3% more of our GDP than the average of 11 other wealthy countries—the rapid growth of HMOs and managed care plans promised to make our healthcare even more effective and efficient.
