ABSTRACT
This chapter’s title in the first edition (2008) was “The Economic Challenge: Impending Chaos.” I have deleted Impending in the update because chaos clearly arrived over the intervening years. Even though the Affordable Care Act (ACA) was not foreseeable in 2008, state and federal governments’ accumulating failures to implement the law as enacted have created widespread confusion and disorder in the medical marketplace. No identifiable entity is in control of health care’s destiny today, and nobody knows for sure where things are headed-sure signs of chaos.
