The motivating thrust behind the former debate has been the lack of relation between increased health care costs and better health, while the latter debate was concerned with the interaction between a declining national domestic product and increasing morbidity and mortality rates. The more general question of viewing health, like education, to be guaranteed by government policy principally as a right, distinguishes the two issues at a more fundamental level. The American federal government has articulated a minimal philosophical commitment to individual health as an end in itself after the Medicare and Medicaid legislation (among the poor and elderly), while the FSU institutionalized a concern with health principally as a means (among industrial workers) for ensuring the goal of economic productivity.