In the last eight or nine years, the rest of managed care, unfortunately, has focused on managing costs rather than care. Managed care should be able to rein in costs by buying the best quality, not just any quality. It doesn't matter at all. I don't think consumers care, and I don't think it's important because it's too complicated. From a consumer's perspective, if someone is managing the care, then he should figure out the best way to pay doctors to get the best outcomes.
Some people buy a car and others lease a car.
It's still the same car. Consumers want to know that however doctors are being paid, they're being paid to maximize outcomes, not to maximize or minimize utilization. It's the managed care company's job to manage that, not the consumer's. I think it's stupid when I hear members of Congress, with whom I speak every week, argue that it's important that consumers know how their doctors are paid. That's because doctors want them to know how they're paid so that consumers will pressure the insurance company to pay them more.