After a brief slowdown, health care inflation in the U.S. is once again
on the rise despite an overall drop in personal health care spending and the
lowest rate of growth for private health insurance since 1997.
Health care spending grew by 6.7 percent in 2006 to $2.1 trillion, or
$7,026 per person, according to research published in the journal Health
Affairs. That growth rate was slightly more than the 6.5 percent seen in 2005,
and the dollar figure represents the largest per capita cost in the
world.
Health care inflation peaked in 2002 at 9.1 percent and then began
trending downward until this year. Still, the 6.7 percent growth seen in 2006 is
still nearly half as much as the 13 percent annual growth that was seen in 1980,
according to the federal government’s national health expenditures as compiled
for the article “National Health Spending in 2006: A Year of Change for
Prescription Drugs.”
Researchers believe that the increase in health care cost inflation is
due to the sharp rise in prescription drug use, fueled by the enrollment of
seniors into Medicare Part D. Investment in drug research and increases in the
cost of administering health insurance offset slowdowns in health care spending
in other areas.
Personal health care spending, which accounts for things like the cost of
health insurance and out-of-pocket costs on medical goods and services, rose 6.6
percent in 2006, slightly less than the 6.8 percent increase seen in 2005. An
18.7 percent increase in Medicare, its largest since 1981 and attributable
mainly to the introduction of a prescription drug benefit, was largely offset by
reductions in spending in Medicaid and a slowdown in the increase of private
insurance.
Medicaid costs decreased by 0.6 percent in 2006, the first decline since
the program’s inception in 1965.
The cost of private health insurance rose at 5.5 percent, its slowest
rate since 1997. According to the article by Aaron Catlin and colleagues in
Health Affairs, a reduction in prescription drug spending among people with
private health insurance largely contributed to the slower growth rate.
Out-of-pocket spending continued its steady decline that began in 1998
when spending on deductibles, co-insurance and payments from health savings
accounts totaled about 15 percent of national health spending. In 2006,
out-of-pocket costs totaled 12 percent of national health spending, which
equaled an annual growth rate of 3.8 percent.
Nonetheless, when out-of-pocket health care costs are combined with
premiums, the household burden of financing health care has remained flat as a
share of personal income since 2003, according to the authors of the
study.
In a companion article in Health Affairs, Paul Ginsburg, president of the
Center for Studying Health System Change, argued that the slight slowdown in
personal health care spending would not last.
Citing a number of reasons, from the increase in obesity to a quickening
of the “medical arms race” to a slowdown in the economy, Ginsburg says that it
would be a “stretch to conclude that the corner has been turned in dealing with
the long-term gap between growth in health spending and growth in income and the
resulting financial pressures.”
The cost-trend data reported in Health Affairs comes amid other reports
that signal health care premiums will remain stable in 2008.
A survey of nearly 3,000 employers by Mercer published in December showed
that group health plan costs rose 6.1 percent in 2007, the third consecutive
year of increase. In 2008, survey respondents expect costs to increase an
average of 5.8 percent after taking into account changes they will make in plan
designs as well as other factors.
—Jeremy Smerd