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Show Health Care Expenditures Compiled by Lars Peterson Health care spending constitutes an important public policy tool, providing a broad look at historical trends and informing policy makers on how much money to budget for health care. Two slightly differing methods of calculating health care expenditures are presented here. The first, national health expenditure (NHE), is shown in Table 20. State health expenditure accounts (SHEA) are shown in Table 21 for Utah, the Rocky Mountain region, and the national aggregate. These data are measures of personal spending for health care services and products in the state in which providers are located. Utilizing the SHEA numbers allows one to look directly at personal health care expenditures. Updated SHEA numbers have not been published since 1998. All of the tables that follow use SHEA tabulations, except one that serves as a comparison and a look at more recent data. The other method of tabulating health expenditures is the national health expenditure (NHE) tabulation. Included in NHE, but not SHEA, are estimates of spending for public health programs, administration, research, and construction of health facilities. The table composed of NHE numbers shows some categories in common with SHEA but also highlights the difference by showing public health and research data. Utah residents spend more per capita for health care than the national average or the average for the Rocky Mountain Region (Colorado, Idaho, Montana, Utah, Wyoming). National health spending in 2000 climbed 6.9 percent, up from 5.7 percent in 1999 and the greatest acceleration seen since 1988. The 1.2 percentage point gain in the rate of spending growth primarily reflects an increase in economy-wide inflation, and only a 0.3 percentage point gain in real spending. The growth in prescription drug spending has exceeded that in other delivery methods the last few years. This growth is expected to continue in Utah and the nation with the aging of the population and new drug therapies for chronic conditions. The marked acceleration of health spending in 2000, combined with smaller increases in 1998 and 1999, signal a reversal of the previous trend of decelerating growth. Several factors portend an increase in health spending trends: rising health-sector wages, legislation that increased Medicare spending, technology, and consumer demand for less restrictive insurance plans. Consequently, pressure will mount on both public and private payers to pay for accelerating health care costs with declining revenues, forcing a reexamination of health care priorities. Table 20. United States National Health Expenditures (NHE), in Millions of US Dollars, by Delivery, 1985-2000 Other Physician, Personal Clinical Home Nursing Health Public Year Hospital Services Dental Health Home Care Health Research Total 1985 166,577 89,812 21,650 5,647 30,680 5,276 11,555 8,302 426,832 1986 177,941 99,562 23,108 6,388 33,508 5,908 12,620 8,968 457,242 1987 192,094 111,717 25,258 6,660 36,331 6,530 13,796 10,070 498,025 1988 209,402 127,363 27,325 8,426 40,505 7,289 15,504 10,810 558,090 1989 229,295 141,944 29,297 10,238 45,673 8,567 17,985 11,756 622,653 1990 253,918 157,539 31,502 12,567 52,705 9,647 20,219 12,656 695,999 1991 279,485 175,003 33,279 14,879 58,315 11,830 22,447 13,871 761,826 1992 302,267 189,721 37,013 18,170 62,304 13,605 24,285 15,048 827,043 1993 319,963 201,239 38,878 21,879 65,713 16,130 27,219 15,587 888,063 1994 332,398 210,483 41,432 26,066 68,325 19,881 30,009 16,252 937,225 1995 343,580 220,534 44,486 30,529 74,574 22,918 31,430 17,094 990,264 1996 355,904 229,392 46,818 33,602 79,911 25,801 33,008 17,834 1,039,975 1997 367,533 240,966 50,168 34,544 85,063 27,755 35,484 18,717 1,091,163 1998 379,184 256,822 53,156 33,575 89,103 30,206 37,904 20,602 1,149,781 1999 392,186 270,255 56,389 32,318 89,268 33,725 40,865 23,054 1,215,554 2000 412,103 286.439 59,958 32,426 92,247 36,729 44,238 25,350 1,299,463 Sources: Centers for Medicare and Medicaid Services, formerly Health Care Financing Authority. [Online] http://www.hcfa.gov. Retrieved 4/7/02. Utah's Health: An Annual Review Volume VIII 65 |