然而，尽管公众指责，医疗保健的根本经济运作体制依然没有改变。

For all the public thrashing, though, the underlying economics of health care remain unchanged.

基于同样原因，保险商也会扩大规模。

Insurers will seek scale for similar reasons.

除了价格竞争外，参加商业性的管理医保计划的人数增长缓慢。那些在大公司工作的雇员已不再向传统的医疗保险计划投保。

On top of the price competition, enrollment in commercial managed-care plans is slowing, since most workers at big companies already have switched from traditional indemnity plans.