The United States has been facing considerable growth in health expenditure for several decades despite a succession of reforms aiming to control it. Two factors are contributing to this trend in particular: firstly, an increase in health care costs for payers (due to the rapid spread of technological progress and the freedom to set prices in a context of imperfect competition), followed by the increase in administrative costs of health insurance organizations (mainly due to competitive strategies between the funds and customer selection). Faced with the resulting funding crisis, the Democrat and Republican electoral programs have given priority focus to reform of the health system: cost control and health insurance accessibility are the key words.