The genesis of the debate over the nation's health care system lies in a paradox: on the one hand, more dollars are being spent on health care in the United States than in any other country; on the other hand, some 15 percent of our citizens do not have health insurance.As a society, Americans spent over $666 billion on health care in 1990 (the latest year for which figures are available) — or 12.2 percent of our gross national product. This compares with a bit more than 7 percent in 1970 and a little over 9 percent in 1980. . . .