ABSTRACT
In the United States, spending on healthcare has risen from around 5.2% of gross domestic product (GDP)in1960to13.6%ofGDPin2000andiscurrently16%ofGDPin2007,themostrecentyearfor whichdataisavailable(OrganisationforEconomicCo-operationandDevelopment2009).Ÿecauses forthisrapidescalationarevariedandcomplex,andadiscussionofthemisbeyondthescopeofthis chapter.Nevertheless,concernoverrapidlyescalatinghealthcarecostsplaysacentralroleintheongoingdebateoverhealthcareinthiscountry,andregardlessofpoliticalorientation,virtuallyeveryone agreesthatprovidinghigh-qualityhealthcarewhilesimultaneouslyreiningincostsisthedesiredgoal. Manyproposedsolutions(whethertheywouldactuallyworkornot!)haveprovenimpossibletoimplementbecausetheyrequireapoliticalconsensusthatsofarhasprovenelusive.Whetherthecurrent healthcaredebatewillchangethatisstillunknown,andevenifpoliticalconsensusforchangeisarrived at,whethertheresultingchangeswillactuallyproveeffectiveissomethingthatwillbeknownforsure only a·er the fact.
