In some of these earlier Chronicles, I wrote about how the American College of Radiology (ACR) was successful in getting radiology defined as a medical service, and not just a hospital responsibility for the Medicare program, which was enacted in 1965. I noted that when the Medicare program began operation, it was managed in various states by Blue Cross, Blue Shield, and a growing number of private health insurance companies. At the beginning, the companies were told to apply the same formats, the same prices, the same staff members, and to accept whatever relationships doctors had with hospitals in their pre-Medicare relationships.
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