Managed care was ushered in by out-of-control fee-for-service inflation. Managed care stole its basic principles from public health and did it better—delivering continuous, coordinated, and cost-effective care at the least restrictive level. Assuring quality is a second-generation concern that is now being incrementally addressed by legislation, litigation, and accreditation. How very American! The National Committee for Quality Assurance now seeks to impose dozens of objective standards on a previously unmanaged health care system. This endeavor will be paid for by increased corporate and government costs, decreased shareholder profits, or industry consolidation and efficiency.