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“Reformers are mostly right when they argue that Congress hasn’t done a great job of controlling health costs or the growth of tax-financed health spending. But where they go wrong is in thinking that a small number of experts in positions of government-granted authority will somehow be more successful. The basic problem with the bureauwonk model of health reform is that it assumes that technocrats can not only identify but successfully scale local innovation to the national level.”

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