When Alaska Gov. Sarah Palin took office, she inherited a healthcare problem common to many states: whether to let small clinics compete freely against hospitals for such services as outpatient surgery and MRIs. Palin responded with an aggressive, uncompromising push to promote competition. Although she has been unsuccessful in the fight to date, the battle Palin has waged over competition in healthcare has been one of her signature efforts since she became Alaska's governor in 2007.