Abstract
THE United States spends more on medical care — both in absolute terms and as a percentage of its gross national product — than any other industrialized nation. American medical care is unsurpassed in technological sophistication, but its costs are very high and rising rapidly. The panoply of cost-containment programs developed over the past decade has had little effect on overall expenditures, but it has had serious consequences in other areas.As government and private purchasers of health insurance constrict benefit packages and restrict criteria for eligibility, a record number of Americans are squeezed out of our health insurance system. . . .

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