First do no harm.
[What's wrong with health care?] Chances are, most Americans would say health care costs too much, that they are spending more and getting less. Health care is expensive and gets ever more expensive. Costs have risen from 5.3 percent of the gross domestic product (GDP) in 1960 to roughly 14 percent in 2000. Health care is now a $1.3 trillion industry, consuming about one-sixth of the U.S. economy. Of the $1.3 trillion, about 45 percent comes from taxes, 34 percent from insurance premiums, and 15 percent directly from patients' pockets. Health care costs the average household $8,000 annually, according to C. E. Steuerle of the Urban Institute.1
Americans have reason to worry that health care will be priced out of reach. All too often, those with health insurance lose their coverage through no fault of their own, becoming part of the 20 percent, or 43 million, without health insurance—a number that has grown by a million persons annually since the early 1980s. The elderly worry about the price of prescription drugs; low wage earners can't afford health insurance coverage for their children; some people with insurance can't afford the copayments and deductibles. Still others are forced into bankruptcy by uncovered medical bills. Disastrous medical bills account for about 40 percent of the bankruptcies filed in 1999.2
Access and quality are also concerns. The media is full of stories about disappearing services and denied benefits. It seems that most of the public knows someone personally who was turned away by a doctor, a hospi