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As a share of its economy, the United States spends more money on health care than any other nation in the world. In 1997, the latest year for which statistics are available, total health expenditures totaled almost $1.1 trillion. The rate of growth has slowed significantly in recent years, as inflation in the health care industry declined from about 7.5 percent in the mid- to late-1980s to just 3 percent in 1996–98. Nevertheless, at about 13.5 percent of GDP (the primary measure of national economic output), health care spending in the U.S. is still much higher than in the nations with the next highest levels -- Germany, France, and Switzerland -- where health care spending accounts for about 10 percent of GDP.

Perhaps not surprisingly, given such high levels of spending, mortality rates in the United States have dropped to an all time low in recent years. In 1997 the life expectancy at birth for an American citizen reached 76.5 years of age, an all time high. By 2030, it is estimated that about 20 percent of all Americans will be aged 65 years or older, up from about 13 percent today. Despite such good news overall, however, the health care needs of Americans are not being uniformly met. In 1997, 16.1 percent of Americans lacked health insurance, up from 15.6 percent the previous year and 12.9 percent in 1987.

Such issues, including health insurance coverage, public health initiatives, health-related research, and major federal programs like Medicaid and Medicare, are the focus of this section.


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