 A possible reason for this failure is that consumers might increase utilization in response to less cost sharing under HMOs.Some have asserted that HMOs (especially those run for profit) actually increase administrative costs and tend to cherry-pick healthier patients.Though some forms of group "managed care" did exist prior to the 1970s, in the USA they came about chiefly through the influence of U.S. President Richard Nixon and his friend Edgar Kaiser.