Health Care: The Causes and Consequences of Slower-Growing Costs

摘要

There is good news about healthcare spending, writes the author. Costs are rising at rates far more slowlly than anticipated. Why? And will it last? It is possible that it will, but it will require vigilance. A little over a decade ago, the Centers for Medicare and Medicaid Services completed its annual exercise in projecting the future of health care spending. The prospects looked bleak. With total costs tipping the scale at 16.6 percent of gross domestic product, up three full percentage points in the prior decade, it seemed inevitable to the economists and actuaries at CMS that spending would close in on 20 percent of GDP by 2017. Their reasoning was captured in the subtitle of the report: "The Baby-Boom Generation Is Coming to Medicare" (Keehan et al. 2008). A decade later, the latest report from CMS belies the notion that demography is destiny. Health-care spending in 2017 grew at its lowest pace in half a decade. Its share of the overall economy stood at 17.9 percent of GDP, which was 1.6 percentage ponts below the 2008 projection. While Americans in the first year of the Trump presidency spent nearly $3.5 trillion, or $10,739 per capita, on health care-a staggering sum compared to other countries-it was nearly $800 billion or $2,362 per capita less than what had been expected a decade earlier (Martin et al. 2019).