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发帖数: 29846 | 1 By LOUISE RADNOFSKY
Economists have been puzzling over whether a three-year slowdown in the
growth of health-care spending, prompted by the economy, portends a
permanent change. Federal projections indicate that isn't the case.
A forecast released Tuesday said the growth rate for U.S. health spending of
all types would stay historically low the next two years. But it would
increase if most of the federal health-care overhaul takes effect in 2014.
After that, the rate would drop, but spending still would grow at a higher
rate than that of the past few years, according to the Centers for Medicare
and Medicaid Services.
The figures, published in the trade journal Health Affairs, suggest the
current soft spending is a short-term trend. Consumers have been cutting
back on doctors' visits and employers have trimmed insurance since the U.S.
first fell into a recession.
National health-care spending growth was 3.8% in 2009, the smallest increase
on record, and was followed by a similar 3.9% in 2010. Economists in the
new report projected similar rises averaging 4% annually for 2011, 2012 and
2013. (Actual 2011 spending hasn't yet been calculated.)
Spending would jump 7.4% in 2014 when the health-care law is scheduled to be
fully implemented, the analysts predict, as millions of Americans gain
coverage through subsidized insurance plans purchased through government-run
exchanges or through Medicaid, the federal-state program for low-income
people.
The fate of the law is uncertain. The Supreme Court could strike down part
or all of it this month, and Republicans—including likely presidential
candidate Mitt Romney— have pledged to repeal it. Democrats have said they
believe the law will be upheld and that they expect to continue to carry it
out.
The federal analysts said their projections could be affected by changes in
the law or economy.
The analysts said most spending increases projected for 2014 would be due to
routine doctors' visits and prescription drugs, as the majority of newly
insured people are expected to be young and relatively healthy. They also
predicted greater spending on health insurance and government administration
if the law takes full effect that year.
Spending growth would slow again starting in 2015 and average 6.2% each year
through 2021, the analysts said.
Overall, the new health-care law would have only a small impact on total
health-care expenditures, they said, because the new outlays would be offset
by provisions expected to reduce spending on Medicare and on some high-cost
health plans.
In all, only 0.1 percentage point of the expected annual average growth
could be attributed to the law, the analysts said, although that comes to
about $478 billion by 2021.
A bigger reason for projected spending growth is the aging of baby boomers
as they make greater use of Medicare, the federal insurance program for the
elderly, the analysts said.
By 2021, health-care spending is likely to be nearly a fifth of the U.S.
economy, at 19.6% of gross domestic product, up from 17.9%, or roughly a
sixth, in 2010. The government share of the spending also would be greater,
at nearly 50%, up from 46%, mostly because of the anticipated growth in
Medicare enrollment. |
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