The chains of hypermarkets that have come to dominate food retailing in France and Spain Similarly control the product mix, manufacturing schedules, and delivery schedules of their main

suppliers. And so do the discount chains that take a growing share of the US market in office products. In the United States, the free-standing community hospital is no longer the principal customer for health-care products. Buying is now done by chains: for-profit ones, such as Humana; voluntary ones; denominational ones, whether Catholic or Lutheran. They set the product specifications, find the manufacturer, negotiate price, and determine manufacturing schedules and delivery.