ed by the states and is partly (50-80 percent) paid for by the federal government. Beginning in the 1970, the federal government and the states also greatly expanded their regulation of environmental hazards in the air and water. Other federal programs initiated in the 1960s include poorly funded Neighborhood Health Centers, the National Health Service Corps and bloc grants to states for the treatment of alcohol, drug abuse and mental health. (Ronald Reagan cut these).
In other industrialized nations, universal health insurance coverage, such as in Germany and Sweden, or national health services, such as in Great Britain, are provided, largely from tax revenues and/or employer contributions. Cochran et al. said that "coverage under foreign health care is generally broader than coverage by public or private insurance in America," (p. 255). About 37-40 million Americans (15 percent of the population) lacked health insurance coverage in 1995 (Cochran et al., 1996, p. 255).
Economic Impact. As a percentage of GDP, Americans spend more, not less, than other countries on health care, in 1993 $884 billion, 14 percent of GDP vs. 9 percent in Britain and 6 percent in Japan (Kuttner, 1999, p. 112). According to Kuttner, total health expenditures grew in the United States between 1965 and 1995 at 2.4 times the annual rate of inflation, as compared with 1.7 times in Britain and 1.2 times in Sweden (p. 155). Rapidly rising health care costs have been fueled by the aging of the population, expensive medical technology, the labor-intensiveness of health care and the cost pressures of the fee-for-service and private and public
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