Right now there is a paradox: We spend more than any industrialized country, but our health is fair to middling among other developed nations.

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Speaking to reporters at a press conference, Commerce Secretary Carlos Gutierrez said the decision "doesn't signal a retreat from economic engagement with China, " but added that the Asian country's economy has developed to the point that trade tools the U.S. employs in its dealings with other industrialized nations can now be used.

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