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The history of public health has been a flourishing field in the last three decades. Yet despite a spate of excellent monographs about various epidemic diseases and many good collections about health and disease in Africa, Asia, The Middle East, Latin America, as well as Europe and North America, the most recent textbook on the history of public health is four decades old.

From a comparative perspective the health system of the United States has a history that is both representative and idiosyncratic.

These days, expenditure on health amounts on average to some 9 per cent of gross domestic product in the prosperous nations of the West. Whether through direct taxation, social security, social health insurance or private means, it’s a substantial amount.