Until recently, the economic machinery of the health care industry ran like no other. Health care did not respond to the traditional laws of supply and demand. It was impervious to external pressure to improve quality or offer better service. It was never in any hurry to operate more efficiently. It didn’t have to tell anyone what it charged for products or services or how well those products or services performed. For most buyers (patients), a disinterested third party (insurers) paid the sellers (hospitals and doctors) for whatever the buyers needed or wanted.