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Perhaps the most serious and complex domestic policy issue facing Congress today is the problem of ensuring the availability of quality health care at a reasonable cost.Health care expenditures have skyrocketed in recent years, far exceeding the general rate of inflation. Between 1981 and 1982, the overall consumer price index increased by 6.5%. During the same time, medical costs increased almost twice as much--11.6%. America is currently spending more than one tenth of its income--10.8% of the gross national product (GNP)mon health care. In 1983, health care expenditures in the United States totaled $355.4 billion, an average of $1,459 per person.This investment has produced some tremendous advances in scientific medicine and technology. Some of these medical achievements, such as Barney Clark's artificial heart, are truly miraculous. Unfortunately, however, it is generally agreed that the huge investment we are making in our health care system is not resulting in corresponding gains in the overall health of the general population.

The effect of bicarbonate ions on induction of Mg2e-ATPase activity, on the N-ethylmaleimide inhibition of phosphorylation and on energydependent adenine nucleotide exchange has been examined with pea seedling chloroplasts. ATP synthesis is stimuiated by bicarbonate in chloroplasts which lack the capacity to fix CO2 (2,8,10,20,21). It had been suggested (8) that the site of action for bicarbonate in producing this effect is at the level of the interaction between the energized thylakoid membrane and the CF12. In the present study, the effect of bicarbonate on the following light-dependent reactions: Mg2+-ATPase activity (3, 4), [32PJPi-ATP exchange activity (6), inhibition of phosphorylation by maleimides (11, 13, 14, 16) and adenine nucleotide exchange (5,9,15,19,22,25,27)

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