Abstract
Despite the perils of predicting the future of our health care system, many people have weighed in on how they expect the delivery of care to evolve. Such predictions are usually based on the conspicuous trend toward industrial-size delivery networks involving large populations enrolled in managed-care plans, vertically integrated medical center conglomerates, and a few giant insurance companies.13 In my view, several subtle trends will have a profound influence on the delivery of health care: the rapid growth of computer-based electronic communication, the fact that a new generation is increasingly comfortable with the electronic transfer of information, and the . . .