The AHIP Institute for health insurers kicks off later this week, and it's going to be fascinating to see what a difference a year makes. The 2010 show had an undercurrent of cautious optimism over health reform, and the fact that the Obama administration was taking a serious stab at bending the cost curve was widely applauded ... and supported by speakers from the upper echelons of the America's Health Insurance Plans association and the Beltway insiders who gave the keynotes.

But as I had noted during my coverage of last year's show, the speakers who are in the trenches had a somewhat different take on the sharp ends-insurance exchanges, bundled payments, paying for quality, etc.-of health care reform.

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