Peterson-Kaiser Health System Tracker How has U.S. spending on healthcare changed over time?
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Transcript of Peterson-Kaiser Health System Tracker How has U.S. spending on healthcare changed over time?
Peterson-Kaiser Health System Tracker
How has U.S. spending on healthcare changed over time?
Peterson-Kaiser Health System Tracker
Health services spending growth picked up slightly in 3rd Quarter 2014
Year over year growth in health services spending by quarter, 2010 - 2014
Source: Kaiser Family Foundation analysis of Quarterly Services Survey
Q1-2010
Q2-2010
Q3-2010
Q4-2010
Q1-2011
Q2-2011
Q3-2011
Q4-2011
Q1-2012
Q2-2012
Q3-2012
Q4-2012
Q1-2013
Q2-2013
Q3-2013
Q4-2013
Q1-2014
Q2-2014
Q3-2014
0%
1%
2%
3%
4%
5%
6%
7%
3.4% 3.4%
4.1%
5.1%
5.8%
5.2%
3.1%
4.0%
5.6%
4.5%
5.2%5.0%
2.8%
4.2%3.9%
4.9%
2.9%
3.7%
5.4%
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Total health expenditures have increased substantially over the past several decades
1970 1976 1982 1988 1995 2001 2007 2013$0.0
$0.5
$1.0
$1.5
$2.0
$2.5
$3.0
$359.9 BillionIn 2013 Dollars
$2.9 Trillion
$74.9 Billion
Total National Health Expenditures In Constant 2012 Dollars
Total national health expenditures, US $ Trillions, 1970-2013
In Constant 2013 Dollars
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
On a per capita basis, health spending has grown substantially
1970 1976 1982 1988 1995 2001 2007 2013$0
$2,000
$4,000
$6,000
$8,000
$10,000
$1,714 per capitaIn 2013 Dollars
$9,255 per capita
$356 per capita
Total National Health Expenditures In Constant 2012 Dollars
Total national health expenditures, US $ per capita, 1970-2013
In Constant 2013 Dollars
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Health spending growth has outpaced growth of the U.S. economy
1970 1976 1982 1988 1995 2001 2007 20130%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
7%
17%
Total national health expenditures as a percent of Gross Domestic Product, 1970-2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health expenditure and financing: Health expenditure indicators", OECD Health Statistics (database). doi: 10.1787/data-00349-en (Accessed on June 25, 2014).
Health spending increases have slowed, and is now on pace with economic growth
1970s 1980s 1990s 2000s 2010-20120%
2%
4%
6%
8%
10%
12%
14%
9.2%
6.6%
4.3%
2.9%3.4%
12.0%
10.0%
5.3% 5.6%
3.0%
GDP Health Spending
Average annual growth rate of GDP per capita and total national health spending per capita, 1970 - 2012
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Spending on hospitals, physicians, and prescriptions has grown at varying rates
1970s 1980s 1990s 2000s 2010-20130.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
10.3%
7.6%
5.6%
3.8% 3.9%
8.2%
12.8%
11.6%
7.8%
1.9%
14.0%
9.6%
5.2%
7.0%
4.8%
12.8% 12.8%
6.2% 6.0%
4.2%
GDP Prescriptions Hospitals Physicians/Clinics
Average annual growth rate for select service types, 1970 - 2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Hospital and physician services represent half of total health spending
Hospitals34%
Physicians/Clinics 21%
Prescriptions 10%
Nursing Homes, 6%
Other PersonalHealth
16%
Other Health10%
Relative contributions to total national health expenditures, 2013Home Health Care, 3%
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Out-of-pocket spending represents a smaller portion of total expenditures than it did in 1970
Total national health expenditures, 1970 and 2013
Out-of-pocket33%
Private Insurance21%
Public Insurance22%
Other24%
1970
Out-of-pocket12%
Private Insurance33%
Public Insurance39%
Other16%
2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Per capita out-of-pocket expenditures have grown since 1970
1970 1976 1982 1988 1995 2001 2007 2013$0
$200
$400
$600
$800
$1,000
$1,200
$573Per capita
$1,076Per capita
$119Per capita
Out of pocket In Constant 2012 Dollars
Per capita out-of-pocket expenditures, 1970-2013
In Constant 2013 Dollars
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of Consumer Expenditure Survey
On average, larger shares of household budgets are devoted to health expenses than 10 years agoAverage portion of household budget devoted to health (nonelderly families), 2002-2012
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
2.1%
3.1%
4.4%
5.2%
Out-of-pocket costs:
Insurance premiums:
Total health expenses:
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of Consumer Expenditure Survey
A larger portion of household spending on health is on insurance premiums, and smaller portion on OOP costsAverage household expenditures on health (nonelderly families with no Medicare beneficiaries), 2002 and 2012
Health insurance51%
Medical services32%
Prescription drugs14%
Med sup.3%
2002
Health insurance59%
Medical services28%
Prescription drugs10%
MedSup.3%
2012
$1,827 $2,754
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Health insurance represents a growing share of total health expenditures, particularly public programsTotal national health expenditures, 1970 and 2013
Out-of-pocket33%
Private Insurance21%
Public Insurance22%
Other24%
1970
Out-of-pocket12%
Private Insurance33%
Public Insurance39%
Other16%
2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Medicare and private insurance growth have been similar, but Medicare growth has slowed recently
1990s 2000s 2010 - 20130%
1%
2%
3%
4%
5%
6%
7%
8%
6.0%
7.0%
3.3%
5.7%
6.5%
0.7%
Private Insurance Medicare
Average annual growth rate of spending per enrolled person in Private Insurance vs. Medicare, 1970 - 2013
Peterson-Kaiser Health System Tracker
Public and private health spending have both grown substantially, but public spending has grown faster
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
$-
$0.2
$0.4
$0.6
$0.8
$1.0
$1.2
$1.4
$1.6
$1.8 Private Public
1987 2013
Total national health expenditures, US $Trillions, 1970-2013
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Peterson-Kaiser Health System Tracker
1970 1976 1982 1988 1995 2001 2007 20130%
1%
2%
3%
4%
5%
6%
7%
8%
9%
4%
7%
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Administrative costs have risen over time but have recently moderated
Net cost of health insurance and administration, as a share of total health expenditures, 1970-2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Spending on public health has increased, particularly by state and local governments
Local and federal expenditures on public health, US $Millions, 1970-2013
19701972
19741976
19781980
19821984
19861988
19901992
19941996
19982000
20022004
20062008
20102012
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Federal State and Local
2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis data
Prices have historically driven health services spending growth, but it’s now a mix of price and useAnnual change in price and quantity indexes of health services, index numbers 2009=100
19811982
19831984
19851986
19871988
19891990
19911992
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20112012
20130%
2%
4%
6%
8%
10%
12%
14%
Real personal consumption expenditure quantity index Price index for personal consumption expenditure
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis data
Growth in the use of pharmaceuticals has outpaced price growth for 2 decades
19811982
19831984
19851986
19871988
19891990
19911992
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20112012
20130%
2%
4%
6%
8%
10%
12%
14%
Pharmaceutical and other medical products quantity indexesPharmaceutical and other medical products price indexes
Annual change in price and quantity indexes of pharmaceutical and other medical products, index numbers 2009=100