excess cost growth in medicare, medicaid, and all other health care spending source: cbo, a federal...
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0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
1975-1990 1990-2005
Per
cen
tag
e P
oin
ts
Medicare
Medicaid
All Other
Total
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
1975-2005
Excess cost growth in Medicare, Medicaid, and all other health care spending
Source: CBO, A Federal Perspective on Health Care Policy and Costs, 2008.
National Health Expenditures as a Percent of GDP
13.8
15.9 16.016.2
16.5
15.4
13
14
15
16
17
1993 2002 2003 2004 2005 2006
Sources: Center for Medicare and Medicaid Services, Bureua of Economic Analysis
the U.S. Spends More on Health Care Than ANY Other Developed Nation
$-
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
1970 1980 1990 2003
U.S.AustraliaCanadaDenmarkFranceJapanNorwaySwedenU.K.
Source: Kaiser Family Foundation, Snapshots: Health Care Costs, 2007.
Total Health Expenditures Per Capita, U.S. and Selected Countries
Increases in Health-Insurance Prices Compared to Other Indicators
0%
2%
4%
6%
8%
10%
12%
14%
16%
2000 2001 2002 2003 2004 2005 2006 2007
Health Insurance Premiums Workers' Earnings Consumer Price Inflation
Source: Henry J. Kaiser Family Foundation and the Health Research and Educational Trust
Employers and employees are spending more on premiums
Source: Kaiser Family Foundation, Employer Health Survey, 2008.
Average Annual Employee and Employer Contributions to Premiums for Family Coverage
$3,354
$2,973
$2,713
$2,661
$2,412
$2,137
$1,787
$1,619
$1,543
$9,325
$8,824
$8,508
$8,167
$7,289
$6,667
$5,866
$5,269
$4,819
$4,247
$3,281
$0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999Employee Contribution
Employer Contribution
Deductibles are rising
Average Aggregate Deductible for Workers with Family Coverage,2006-2008
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
$1,800
$2,000
HMO PPO POS
Plan Type
2006 2007 2008
Source: Kaiser Family Foundation, Employer Health Survey, 2008.
Higher copayments increase the burden on insured workers
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
2008
2007
2006
2005
2004$5
$10
$15
$20
$25
$30
Other
Source: Kaiser Family Foundation, Employer Health Survey, 2008.
Distribution of Copayments for an office visit with a Primary Care Physician
Percentage of Americans Not Covered
13%
14%
15%
16%
1999 2000 2001 2002 2003 2004 2005 2006 2007
Percent Under 65 Covered By Employers
62%
63%
64%
65%
66%
67%
68%
69%
1999 2000 2001 2002 2003 2004 2005 2006 2007
Coverage Under Employer InsuranceIs Flat…
150,000
155,000
160,000
165,000
170,000
175,000
1999 2000 2001 2002 2003 2004 2005 2006 2007
…In a Growing Eligible Population
150,000
155,000
160,000
165,000
170,000
175,000
1999 2000 2001 2002 2003 2004 2005 2006 2007
240,000
245,000
250,000
255,000
260,000
265,000
Covered
Population Under 65
Percentage of Firms Offering Health Benefits
66
63
60
61
60
66
68
69
59
61
63
65
67
69
71
2000 2001 2002 2003 2004 2005 2006 2007
Source: Henry J. Kaiser Family Foundation and the Health Research and Educational Trust
Source: Kaiser Employer Health Survey, 2008.
Small Firms Are Less Likely To Offer Health Benefits
40%
50%
60%
70%
80%
90%
100%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Small Firms (3-199 workers) Large Firms (200+ workers)
Percentage of Firms Offering Health Benefits
Workers Covered by Employers’ Health Benefits
Source: Kaiser Employer Health Survey, 2008.
Health-Insurance Coverage Is Lower in Small Firms
Employer Coverage Is Falling;Uninsured Percentage Is Rising
14.0%13.7%
14.1%
15.1%14.9%
15.3%
15.8%
15.3%
14.7%
68.3%
67.1%
64.4%
63.9%63.5%
67.9%
62.9%62.9%
65.7%
11%
12%
13%
14%
15%
16%
17%
18%
1999 2000 2001 2002 2003 2004 2005 2006 2007
62%
63%
64%
65%
66%
67%
68%
69%Under 65, Covered By Employer
Uninsured
Source: U.S. Census Bureau.
Infant Mortality Rates, 2004
6.8
5.3
5.0
4.7
4.1
3.9
3.5
3.1
2.8
0 1 2 3 4 5 6 7 8
United States
Canada
England and Wales
Australia
Germany
France
Spain
Sweden
Japan
Infant deaths per 1,000 live births
Infant mortality rate in the U.S. is higher than in other developed countries
Source: National Center for Health Statistics, Health, United States, 2007.
Few Private Employee-Enrollees Can Save ByChoosing a Less-Expensive Insurance Carrier
Source: Marquis and Long, “Trends in Managed Care and Managed Competition, 1993-97,” Health Affairs, 18, no. 6 (1999).
No choice of carrier, 77%
Choice but zero potential savings,
9%
Choice but only partial savings,
8%
Choice with full savings, 6%
Source: Peter Orszag, CBO, Presentation to the Center for Public Health, Stanford University
Medicare Spending per Beneficiary,by Hospital Referral Region, 2005
Source: Elliot Fisher, Dartmouth Medical School.
42.2
23.9
$50,522 19.2 52.1 2.9
$40,181
17.7
1.0
$26,330
12.9
1.1
Total MedicareSpending*
Hospital Days* Physician Visits* Ratio, medicalspecialist/primary care*
UCLA MedicalCenter
MassachusettsGeneral Hospital
Mayo Clinic
82
86
90
CQS**
Cost and Performance at Three High-Quality Medical Centers
*Care Delivery and Spending Among Medicare patients in last 6 months of life.**CMS Composite Quality Score: an aggregate of all quality measures within each clinical area.
Source: The Dartmouth Atlas of Health Care, 1995-2005.
Health Care Is Less Expensive in the Upper-Midwest
Total Medicare reimbursements per enrollee: U.S. vs Upper-Midwest
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
1995 1997 1999 2001 2003 2005
US
IA
MN
WI
