Although a median-income US family of four with employer-based health insurance saw its gross annual income increase from Dollars 76,000 in 1999 to Dollars 99,000 in 2009 (in current dollars), this gain was largely offset by increased spending to pay for health care. Monthly spending increases occurred in the family's health insurance premiums (from Dollars 490 to Dollars 1,115), out-of-pocket health spending (from Dollars 135 to Dollars 235), and taxes devoted to health care (from Dollars 345 to Dollars 440). After accounting for price increases in other goods and services, the family had Dollars 95 more in monthly income to devote to nonhealth spending in 2009 than in 1999. By contrast, had the rate of health care cost growth not exceeded general inflation, the family would have had Dollars 545 more per month instead of Dollars 95-a difference of nearly Dollars 5,400 per year. Even the Dollars 95 gain was artificial, because tax collections in 2009 were insufficient to cover actual increases in federal health spending. As a result, we argue, the burdens imposed on all payers by steadily rising health care spending can no longer be ignored.
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