"O'Kane, of the NCQA, trots out a metaphor that she's heard at health care conferences she's attended over the years. "The American health care system is like buying a car where they come and put the parts on your lawn. What we're all looking for is the entity that puts it all together and that is able to be accountable for the performance of the vehicle, rather than whether you got good spark plugs."

If this is a system, it's not a very
good one.