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It is an astounding number, but health care expenditures in the United States now account for approximately $2.5 trillion, or approximately 17 percent of our gross domestic product, and are projected to rise to 20 percent in coming years. Congress and the Obama administration are struggling with ways to control Medicare and Medicaid expenditures, and health care costs in general. Most experts agree that vigorous competition—even in a sector that is awash in government money and federal and state regulations—is a critical factor in reining in these escalating costs.

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