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In 1980, U.S. health care spending took up 8.7 percent of GDP. Other industrial countries were in the 6 to 9 percent range.
In 2002, U.S. was at 14.6 percent of GDP (over 15 percent today), and other countries were in the 8 to 11 percent range.
Today, U.S. spends about $5000 per person per year on health care, compared with $3000 per person per year in other countries
Impact: Medicare and Medicaid budgets strained; employer-provided health insurance deteriorating; millions uninsured
Common Scapegoats (not really the problem, but people like to blame):
--drug companies; but drug company profits are less than 3 percent of total health care spending
malpractice insurance; also small relative to health care spending
--insurance companies; but overhead is less than 8 percent of health care spending
--spending on the last year of life; only 7 percent of total health care spending;
Increase in Physicians, by specialty, in the U.S., 1975-2002 (overall population rose 35 %)
| Specialty | Percent Increase |
|---|---|
| All Physicians | 111 % |
| General Practice | 55 % |
| General Surgery | 26 % |
| Internal Medicine | 242 % |
| Pediatrics | 228 % |
| Cardiovascular | 237 % |
| Gastroenterology | 433 % |
| Pulmonary | 472 % |
| Neurology | 385 % |
| Diagnostic Radiology | 704 % |
In 1980, 3.6 million CT scans. In 2003, 50.1 million
In 1980, 0 MRI's. In 2003, 24.2 million
Medical technology constantly changing--a doctor's office looks very different today than in 1970's
Over time, we have seen longevity increase, improved health among the elderly, and reduced chronic illness across the population
Some specific treatments are proven successes: beta blockers, for example
Anecdotes of successful interventions
Comparisons of populations receiving more or less premium medicine show no difference
Some evidence that medical services determined by supply, not proven value
Other countries control spending through reduced availability, different cultural expectations
summary: U.S. spends much more than we did 25 years ago on health care; spends more than other countries; evidence is mixed on whether we are getting our money's worth; main cause is the capital-intensive mix of health care services;