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Re-engineering healthcare

The New York Times, March 27, 2013
The chief executive of Kaiser Permanente, which is often hailed as a model of health care reform and cost control, said in a Times article recently that "the future of health care is going to be rationing or re-engineering." Consumers tend to dislike the idea of rationing, but would it be better than the alternatives? If "re-engineering" means consolidation and vertical integration, is that a good thing for patients? For the industry?