Expenditures

The United States operates a health care system that is unique among nations. It is the most expensive of systems, outstripping by over half again the health care expenditures of any other country.1 The number of people without insurance continues to increase, however, reaching 43.4 million, or 16.1 percent of the population, in 1997 — the highest level in a decade.2 By many technical standards, U.S. medical care is the best in the world,3 but leaders in the field declared recently at a national round table that there is an “urgent need to improve health care quality.”4 The stringency of . . .