Introduction

That the cost of health care in the United States is staggering —and on the rise —should be of no surprise to anyone. U.S. Department of Commerce data (cited in Haber & Mitchell, 1997) indicate that in 1980, the per capita annual health care cost was $1,068. By 1993, this figure rose to $3,299. Selden (1997) noted that over the past four decades, the cost of health care has exceeded general inflation by 50%, whereas during 1995, health care price inflation was 60% higher than increases in prices generally. Ray (1996) reported that the cost of health care in 1995 was about $1 trillion, or 14.9% of gross domestic product, and that figure is expected to rise by 20% by the year 2000.