Largest One-YearJump in Health Spending

According to a recent Health Affairs paper, health care spending as a share of GDP grew by the largest percentage point increase since the U.S. government has tracked national health expenditure. Not only did the numerator (health spending) increase–especially for public spending–but the denominator also decreased (i.e., GDP). The article begins as follows: “National health spending is estimated to have grown 5.7 percent and reached $2.5 trillion in 2009, despite a projected 1.1 percent decline in gross domestic product, up from 4.4 percent in 2008. The result is an expected rise in the health share of GDP of 1.1 percentage points, to 17.3 percent. This projected rate of escalation would represent the largest one-year increase in the health share of GDP since the National Health Expenditure Accounts (NHEA) began tracking health spending in 1960, and it reflects the severity of the recession that began in 2007… Health spending by public payers ($1.2 trillion) is projected to have grown much faster in 2009 (8.7 percent) than that of private payers (3.0 percent, to $1.3 trillion). A leading driver of the acceleration among public payers, up from 6.5 percent in 2008, is the expected growth in Medicaid enrollment (6.5 percent) and spending (9.9 percent) as a result of rising unemployment related to the recession. The relatively low growth of private-payer spending in 2009 was influenced by private insurance enrollment that is expected to have declined 1.2 percent. The decline occurred despite a substantial boost from federal subsidies provided by the American Reinvestment and Recovery Act (ARRA) of 2009.” Sources:

• • Christopher J. Truffer, Sean Keehan, Sheila Smith, Jonathan Cylus, Andrea Sisko, John A. Poisal, Joseph Lizonitz and M. Kent Clemens. Health Spending Projections Through 2019: The Recession’s Impact Continues. Health Aff February 2010 10.1377/hlthaff.2009.1074

• Andrea M. Sisko, Christopher J. Truffer, Sean P. Keehan, John A. Poisal, M. Kent Clemens and Andrew J. Madison. National Health Spending Projections: The Estimated Impact Of Reform Through 2019. Health Affairs, 29, no.10 (2010):1933-1941.