Health care in the United States is changing rapidly. The traditional system—a fragmented array of hospitals and clinics administered largely by government and nonprofit organizations—is giving way to a regime of managed care run increasingly by the private sector. The ascent of managed care has triggered a spate of multibillion-dollar takeovers and mergers among insurers, pharmaceutical companies, and biotechnology firms, all of which have been looking for ways to capture market share, expand their businesses, and ensure survival in a time of slow growth and relentless competition.
A version of this article appeared in the July–August 1997 issue of Harvard Business Review.