How – your – health care spending has changed.

Do you feel like you are spending more on your healthcare? Your share, that is.

Chances are you are right. Years of cost shifting by employers and insurance companies – even Medicare have had their impact. Higher deductibles, higher co-pays, etc.

The purpose of all that was to save money – for the those paying for most of the spending. The stated and theoretical purpose was to give patients a stake in the cost of their care, to make them more conscientious consumers – it didn’t work.

Source: 4 charts showing how health care spending has changed | BenefitsPRO


  1. I am a retired physician. A small number of patients engaged in “doctor shopping” thus incurring larger bills for third party payers to settle. While cost shifting through higher deductibles and co-pays might temper that behavior, it may also discourage many more from seeking care they need. HSA plans used in conjunction with high deductible plans seems like a better way to promote wise consumer behavior. Nevertheless, we must also remember that anyone, even the most health-conscious, because of genetics, accident or bad luck can develop a serious and expensive injury or illnesses. Those souls need timely, high quality compassionate care, not lectures about consumption.


  2. No, no, no. To quote the study:

    “… Total OOP spending increased between 2015 and 2019, although at a significantly lower rate than overall spending. The cumulative increase over the five-year period was 12.3%. In comparison, the cumulative growth in total spending was 21.8% over this period [Figure 9]. Annual OOP spending per person (among all individuals,
    including non-utilizers) was the same in 2018 and 2019, decreasing by $1 ($830 vs. $829). From 2015 to 2018 OOP spending per person increased steadily at about 4.0% per year. The share of OOP spending attributable to each service category remained constant over the full five years, with the highest percentage of OOP spending on professional services [Figure 10]. Cumulative growth in OOP expenditures per person, totaling $91 between 2015 and 2019, was largely attributable to an increase in professional and outpatient services [Figure 11]. …”

    That is an increase of $91 over four years during the period 2015 – 2019. We are talking about < $1,000 a year per capita out of pocket spending. And, that is an average. If you looked at a median amount, it would be noticeably less. As a percentage of total medical spend per capita, out of pocket is only about 10% – 12% of total medical costs. Keep in mind that this has been the situation for decades, because, back in the 1970's we paid about 1/3 of all medical costs out of pocket.

    That is, at least with respect to employer sponsored medical plans, there has been a decided cost shift from point of purchase cost sharing (deductibles, copayments, coinsurance, excluded items, etc.) to point of enrollment cost sharing (premiums, and to a lesser extent, an increase in the worker's contribution). The shift is much less pronounced for union and public sector health plans.

    For others, many, perhaps most American workers pay contribution amounts for single coverage that have LESS IMPACT ON TAKE HOME PAY when compared to:
    Contributions from 35 years ago, in 1985, and
    Contributions for Medicare Part A coverage that we make for current retirees (FICA-MED), and
    Contributions we make (via general revenue taxes) for others (Medicare Part B, Part D, and Medicaid).

    I used to do these comparisons regularly, each year starting with the passage of Health Reform in 2010. I last updated the analysis in 2015. I used Kaiser Family Foundation and World at Work data, as well as wage data from the Bureau of Labor statistics. Given the modest changes in the data shown above, I am highly confident the relationship remains.

    Many American workers are overinsured, in part because they live paycheck to paycheck.

    Over the past 40 – 50 years, the portion of our total rewards allocated towards the cost of health coverage continues to increase – in part depressing the rate of increase in wages and other, non-health coverage components of the total rewards package from employment.


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