This is the seventh edition of a book conceived in 1990 and first published in 1993. The world of health economics has changed since 1990. Our first (1993) edition made but a single reference to“managed care.” Until this seventh edition, we spoke of the United States as the only country with-out a universal health insurance plan. This, of course, changed with the passage of the Patient
Protection and Affordable Care Act (PPACA) in March 2010.
