ABSTRACT
The United States spent an estimated $838 billion for health care in 1992, and these expenditures are expected to be well over $1 trillion by 1995 and may be $2 trillion by the turn of the century. Economic forecasts suggest that the increasing proportion of the gross domestic product (GDP) devoted to health care may have serious consequences for the economic viability of the U.S. economy in the 21st century. Despite the enormous costs of our health-care system, the system is inequitable, denying access to between 32 and 38 million Americans who have no insurance coverage. Perhaps most disturbing is that we know remarkably little about the relationship between expenditures on health care and health outcomes.
