The Growth of Health Spending in the USA: 1776 to 2026 (original) (raw)
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2013
This paper provides a most detailed reconciliation to date of the National Health Expenditure Accounts (NHEA), the official estimates of health care spending in the United States from the Centers for Medicare and Medicaid Services (CMS), and the estimates of health expenditures that are part of gross domestic product (GDP) produced by the Bureau of Economic Analysis (BEA) as part of the national income and product accounts (NIPAs). For the period from 1997-2008, the estimates of total national health spending in the NHEA and in the GDP data are relatively similar, differing by less than 2 percent annually. Well over 90 percent of the total estimated expenditures in the two accounts appear to consist of the same expenditures. The differences in the estimates of expenditures for specific categories of health care – physician services, hospitals, drugs, health insurance, investment in equipment, and government programs – are, however, proportionately larger. The differences in the esti...
Escalating Health Care Spending: Is It Desirable Or
2000
This study analyzes changing trends in U.S. health spending and concludes that although the long-term growth trend has been a good predictor of future spending, pe- riodic differences in the growth trend are important. Of particular concern is the rapid accel- eration in health spending beginning in 1998. If left unchecked, the current growth rate will result in almost 24
Health Care spending: An Analytical Forum
Health Affairs, 1994
One of the most compelling health policy questions to come before the nation in 1994 was whether the rising rate of health care spending meant that the nation s health care system needed an overhaul. A critical part of this debate-fueled by both data and speculation-was the growing perception that in 1993 health care costs, while continuing to rise, had risen less sharply than has been the case in the past thirty years. This sense that health care spending had moderated may have taken some of the sense of urgency away from the calls for health system reform that echoed during the first two years of the Clinton administration. As economist Henry Aaron of The Brookings Institution observes, the issue is "not merely a spat among people who, figuratively, wear green eyeshades and arm garters." Here we present the latest health spending figures from analyst
A Three-Essay Empirical Analysis of Health Care Expenditures In the Economic Development of the United States, 2000-2009 Srimoyee Bose, M.A. Healthcare spending (both per capita and total) in the United States (US) is the highest in the world. The ever-increasing healthcare spending without a corresponding improvement in health outcomes of individuals in the US requires a closer examination of state-level polices and characteristics. As state governments are a vital driver of healthcare implementation and as healthcare policy responses in containing healthcare expenses and outcomes vary among states based on the underlying state-level factors, it is critical to examine state-level variations in healthcare financing, expenditures and outcomes. Therefore the purpose of this study was to empirically demonstrate state-level variations in financing of healthcare, hospital expenditures and health outcomes. Furthermore, empirical analyses demonstrated in this research that the association between state-level variations in healthcare needs, demographic composition, socioeconomic , and political factors affect not only the individual state but also its neighbors. Precisely, aims of the three studies were to: (1) evaluate the state-level variations in healthcare financing and the factors that affect financing of healthcare, (2) examine the state-level variations in hospital expenditures with an application of spatial regression, and (3) assess the determinants of state-level mortality rates using a spatial Durbin fixed effect model. This research used panel data from 2000 through 2009, extracted from publicly available data files. Findings from the first study were that state-level variations in public financing of health care (Medicare and Medicaid) are associated with demographic composition (proportion of the female population, percentage of individuals over age 65, percentage of Hispanic population), economic factors (unemployment rate, per capita gross domestic product (GDP) of the state, per capita state tax revenue, FMAP rate), political climate (percentage of individuals enrolled in Medicare or Medicaid, rate of enrollment in HMO), healthcare supply factors (active physicians per 100,000 population, number of hospitals and beds) and healthcare needs (obesity rate). Additionally, variations in state-level private insurance financing was proportional to the economic factors (rate of federal funding, per capita state GDP), a supply side factor (active physicians per 100,000 population), political climate (percentage of individuals enrolled in Medicare or Medicaid) and healthcare needs (obesity rate). Lastly, state-level variations in out of pocket expenditures were associated with economic factors (per capita state tax revenue, per capita state GDP), demographic factors (percentage of African-Americans, percentage of female population, percentage of elderly population (aged 65 and above), percentage of Hispanic individuals, proportion of the population below age 17), a supply side factor (active physicians per 100,000 population), political characteristics (percentage of individuals enrolled in Medicare or Medicaid) and healthcare needs (obesity rate). The second study reported the presence of a positive spatial dependence of hospital spending within one state on its adjacent states. This study also highlighted that rate of binge drinking, total number of hospital beds and hospitals per 1,000 residents, the unemployment rate, the percentage of African-Americans, proportion of active physicians and state gross domestic product (GDP) had ACKNOWLEDGMENTS I would like to thank Professor Tesfa G. Gebremedhin immensely, for his guidance and mentorship throughout the entire preparation of my dissertation. I am indebted to his encouragement and advise that has helped me to proceed and complete my dissertation. I would like to express my sincere gratitude to Professor Alan R. Collins, Professor Gerard E. D Souza and Professor Peter V. Schaeffer for their valuable guidance, support, suggestions and encouragement throughout this phase. I am very much grateful to Professor Tami Gurley Calvez for lending her immense support and providing me with ideas and propositions to proceed in the dissertation. I am highly indebted to Professor Usha Sambamoorthi for her patience, advise, insight and constant guidance in writing my dissertation and also offering me the research assistant position where I had an invaluable experience in learning new essential software and working on Medicare and Medicaid beneficiaries data. I sincerely thank the staff and members of the Natural Resource Economics Program for providing me with the invaluable assistance and travel supports for various conferences that helped in improving my ideas to a significant level. I extend my gratefulness to the Bureau of Business and Economic Research, Regional Research Institute, Claude Worthington Benedum Foundation and the Department of Pharmaceutical Systems and Policy for providing me with the much needed financial support and assistance throughout my four years course of study. Lastly, I would also like to thank my fellow friends at my subject field, my parents, brother, sister, brother in law and well-wishers whose enthusiasm and moral support inspired me to implement the study and collect data and achieve complete success with my dissertation.
Economic Boundaries of Health Policy: Factors Influencing 1993 - 94 Reform Proposals
International Journal of Health Services, 1996
This article offers a theoretical framework for understanding the crisis of U.S. health care system and the mainstream debate on restructuring health care financing and delivery subsystems. The author argues that the crisis of the health care system is a cause and a consequence of the long cycle of structural changes in the U.S. economy since World War II. The article distinguishes between the level and the rate of growth of health care expenditures. It is possible to moderate the level of health care expenditure by adopting measures in the direction indicated by the historical experience of other advanced capitalist economies. However, in the long term the rate of growth of health care costs will exceed the rate of growth of gross domestic product, thus any attempt to limit it will result in deterioration in the quantity and quality of health care services. The 1993-1994 mainstream debate is revisited to show how these proposals were a part of the overall effort to resolve the long-term problems of the U.S. economy. The defeat of the Clinton plan was due to its concerns with efficiency of the health care system in the face of the demand by a majority of the U.S. capitalist class to cut costs.
New Estimates of Cross-National Health Expenditures * Income and Price Elasticities
This article reexamines cross-national health expenditure relationships, and shows that omitting price terms will bias calculated income elasticities upward. Using health services purchasing power parity indices to control for price, the best income elasticity estimates for 1980, 1985, 1990, 1993, and 1996 are between 1.4 and 1.5. The best price elasticity estimates are between-0.6 and-0.7. A crosscountry comparison validates the premise that through the 1980s into the mid 1990s, national health services, national health insurance systems, or mixed insurance systems exerted more control on spending per capita than did traditional sickness insurance systems.
Health care spending in 1994: slowest in decades
Health Affairs, 1996
Spending for personal health care services in the United States has for surpassed that of any other industrialized nation for many years. In the past two years, however, aggregate spending growth has begun to ease. This paper contains the latest health spending estimates, which confirm this welcome new direction. However, us its authors point out, a two-year observation does not necessarily constitute the beginning of a long-run trend. The estimates were prepared, us they are annually, by the Office of National Health Statistics in the Health care Financing Administration's Office of the Actuary. A National Health Accounts team led by Katharine Levit prepared them. The National Health Accounts are composed of all of the services rendered and sources of funding-private and publicfor each type of service. As such, they represent the most comprehensive snapshot available of health care expenditures in relation to the national economy. The paper also discusses one of the contentious issues on which the Clinton administration and Republicans differ: whether Medicare spending is growing more rapidly than that of private insurance and the reasons that account for the measurable difference. The trends in health care spending are the subject of endless fascination for analysts because they indicate the directions in which the system is moving. In a Perspective that follows, economist Uwe Reinhurdt underscores the notion that the system, viewed in toto, is like a balloon-squeeze it in one spot and it is likely to bulge out at another. Here he discusses the implications of the declining length of hospital inpatient stays. Reinhardt is the James