CBO (Congressional Budget Office): Technological Change and the Growth of Health Care Spending

摘要

For nearly all of the past four decades, spending on health care in the United States grew more rapidly than the economy. As a result, the share of national income devoted to health care nearly tripled. This ongoing spending growth pervaded all parts of the health system including the nations public insurance programs. Although many factors contributed to that growth, most analysts have concluded that the bulk of the long-term rise resulted from the health care systems use of new medical services that were made possible by technological advances, or what some analysts term the increased capabilities of medicine. Major advances in medical science have allowed health care providers to diagnose and treat illness in ways that were previously impossible. Many new services are very costly; others are relatively inexpensive but raise aggregate costs quickly as ever-growing numbers of patients use them. Technological innovation can theoretically reduce costs and, for many types of goods and services, often does. Historically, however, the nature of technological advances in medicine and the changes in clinical practice that followed them have tended to raise spending. Direct measurement of the impact of technological change on health care spending is difficult. The Congressional Budget Office (CBO), on the basis of a review of the economic literature, concludes that about half of all growth in health care spending in the past several decades was associated with changes in medical care made possible by advances in technology. The factors that account for most of the rest of the growth include rising income and changes in insurance coverage, which increased demand for medical care, as well as rising prices in the health care sector.