Spending on health in the US is projected to reach almost 20% of GDP by 2022

BMJ 2013; 347 doi: (Published 19 September 2013) Cite this as: BMJ 2013;347:f5721
  1. Bob Roehr
  1. 1Washington, DC

American spending on health is projected to grow to 19.9% of the economy in 2022, compared with 17.9% in 2011, the latest analysis by actuaries at the Centers for Medicare and Medicaid Services (CMS) published in the journal Health Affairs has shown.1

Expenditure over the next decade is expected to grow at an annual rate of 5.8%, or one percentage point faster than the expected growth in the gross domestic product (GDP).

Spending in 2014 will increase at a faster rate of 6.1%, due largely to an improved economy and consumers catching up on deferred health spending. However, about a quarter of the increase (1.6%) will be attributed to implementation of the provisions of the Affordable Care Act.

The federal government will pick up a larger share of the total healthcare tab over the next decade, with portions paid by Medicaid growing from 15% to 17%, and by Medicare from 21% to 22%. Private health insurance will constitute about a third (33%) of all spending throughout the period, while out of pocket spending by consumers will shrink from 11% to 9% of total spending.

Where the money is spent is expected to remain stable, with the greatest portions going to hospital care (33%), physician and clinical services (20%), and prescription drugs (9%).

The growth in health spending traditionally has slowed during economic downturns and observers have wondered whether the current historic low rate of growth is primarily the result of the recession.

The paper’s lead, Gigi A Cuckler, told the BMJ, “We are not convinced that relationship has been broken in the last couple of years.”

That dashes the hopes of some that structural changes, reforms in how care is delivered and paid for, might have contributed significantly to the slow increases in spending.


Cite this as: BMJ 2013;347:f5721


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