ABSTRACT
It was not until 1965 and the passage of Medicare and Medicaid that the United States provided health care benefits for some Americans-the aged and the poor. When European governments were introducing social insurance programs, the U.S. government was not deeply involved in regulating either the economy or the health services. Although this has changed, Americans have historically been less committed to government welfare programs and more in favor of private enterprise in dealing with economic and social problems. However, except for the elderly, participation in the welfare system is still not considered normative in the United States, and those Americans under the age of 65 who do receive welfare benefits tend to be stigmatized and have low social status. In Europe, providing welfare and social security for the general population, not just the poor and elderly, is a normal feature of the state's role. This situation implies a fundamental difference in the social values of Americans and Europeans, with Americans stressing individualism and Europeans viewing government in a more paternalistic fashion.
