Fee-for-service plans--with their equally problematic incentives for doctors to provide too much costly treatment--continue to shrink.

CNN: Backlash Against HMOs

Many other states are looking at shifting their dual eligible populations to either the fully capitated system that California has adopted or managed fee-for-service plans.

FORBES: California Will Shift 456,000 Low Income Seniors Into Managed Care

The tragedy is that Medicare Advantage architecture is far from perfect and HHS could save money if it wanted to, in particular by targeting the private fee-for-service plans that mimic all of traditional Medicare's dysfunctions except with an element of private profit.

WSJ: Review & Outlook: About That 'Scalpel' . . .