Health Care Costs: On the Rise Again

摘要

Between 1993 and 1999, something extraordinary happened with U.S. health expenditures: they declined as a share of national income for the longest period since the Great Depression. While per capita costs had grown at an inflation adjusted annual average rate of 4.7 percent between 1950 and 1993, they grew at less than half this rate―less than 1.9 percent―between 1993 and 1999. By 1999, health care spending was 25 percent lower than might have been expected based on historic growth rates. This moderate rate of growth in health care costs conferred many benefits. Medicare costs grew more slowly than expected, which helped move the federal government's budget from deficit to surplus. Slower growth of Medicaid, in tandem with new federal matching funds through the 1997 State Child Health Insurance Program (SCHIP), prompted states to expand health insurance coverage, making nearly 30 million children eligible for public health insurance coverage (Cunningham, 2001). Lower increases in employer sponsored health insurance premiums contributed to the largest increases in real wages observed since the early 1970s (Council of Economic Advisers, 2001). Individual purchasers of health insurance realized savings, too. Between 1998 and 2000, for the first time in more than a decade, the percentage of Americans who were uninsured fell.