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Health Maintenance Organizations (HMOs)

Managed-care programs, entailing the integration of insurance and care providers with fixed rates for services (and sometimes pharmaceuticals) as well as health incentives (physical fitness programs, etc.) came to dominate American healthcare in the late twentieth century. While praised for controlling costs and sometimes rationalizing care, they have also been criticized for their drive to keep expenses at a minimum and their corporate remodeling of the relationship and autonomy of doctors, nurses and patients.

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