spends approximately 15% of its gross domestic product on health care, making it the largest sector of the economy” (Goldman, D., & McGlynn , E., 2005) . “Americans are no healthier than other developed countries, despite these high costs” (WHO, 2010). “Nearly 40 million Americans are uninsured, and approximately 18 percent of Americans under age 65 receive half of recommended health care services” (Goldman, D., & McGlynn, E., 2005). “However, it has been noted that the quality of care does not vary much across cities with respect to lack of insurance, poverty, managed care penetration, and availability of physicians and hospital beds” (Goldman, D., & McGlynn, E., 2005). Roles and main activities of the public and private sectors