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August 14, 2013

The State of Health in the United States

Author Affiliations
  • 1Institute of Medicine, Washington, DC
JAMA. 2013;310(6):585-586. doi:10.1001/jama.2013.13809

In the mid-1970s, John Knowles assembled a group of leading health thinkers whose essays were published in Daedalus and then released as a book entitled Doing Better and Feeling Worse: Health in the United States.1 In the decade between 1965 and 1975, health expenditures in the United States had more than tripled, from $39 billion (5.9% of gross domestic product) to $119 billion (8.3% of gross domestic product). The premise of the book, as Knowles explained in his introduction, was that “… there was a profound national concern that, despite a massive increase in health expenditures … the nation’s health has improved less than was promised or expected. The benefits have not appeared to justify the costs.”