11.   But if they chose not to do so, the state could step in and contract with private organizations to provide managed care in those areas.

12.   But managed care executives said the marketing added significantly to costs.

13.   But managed care practices permit patients to spend less and less time in hospitals.

14.   But many managed care plans have refused to pay even the routine medical costs for people who enroll in such trials.

15.   But Ms. McCaughey disputed that contention, arguing that more managed care could provide better service because patients would see one doctor on a continuing basis.

16.   But plan executives say they must test new strategies to manage care.

17.   But representatives of the insurance industry said it was a mistake to add another mandate to managed care.

18.   But managed care networks generally are cheaper, experts point out.

19.   But their fears for their own livelihoods, that managed care would cut their wages or drive them out of medicine, are proving overdrawn.

20.   Chiles said the current system was riddled with regulations which prohibit competition and managed care in nursing homes and prevent him from expanding coverage to the working poor.