This Article reviews the history of hospital rate setting in New Jersey, emphasizing the system\u27s evolution in response to newly perceived problems and changing political forces. The system experienced some early success in controlling cost growth and demonstrating new techniques of hospital rate setting. In later years, rate setting in New Jersey has been less successful at confronting a new federal role and the growing problem of health care access. The problems faced by New Jersey hold lessons for both the federal government as it pursues cost containment and the other states who either operate rate regulation systems or contemplate them for the future