Working Americans using less health care, but paying more, report says
Among people with employer-sponsored insurance and their dependents, health care spending increased by 4.6 percent in 2016 compared to 4.1 percent in 2015. The analysis from the independent, nonpartisan
Nearly all of the spending growth can be attributed to price increases, not to increases in utilization, said
"It is time to have a national conversation on the role of price increases in the growth of health care spending," Brennan said in a statement. "Despite the progress made in recent years on value-based care, the reality is that working Americans are using less care but paying more for it every year."
In particular, rising prices for prescription drugs, surgery and emergency department visits contributed to the spending growth.
"The average cost of specialty drug prescriptions increased 158 percent from 2008 to 2016, and brand-name prescription inflation is rising 15 times faster than the Consumer Price Index," she said, adding that unnecessary emergency department visits and surgeries, such as hip and knee replacements, are also factors.
"People don't necessarily understand how directly connected premiums are to what doctors, hospitals and drug companies charge," she said. "Also, new drugs and new technologies don't necessarily provide better outcomes, but they are usually more expensive. We work to balance access to evidence-based care with cost effectiveness."
Public health and economics expert
While the report found that out-of-pocket spending for consumers also increased, the rate was slower than total spending, but Brennan said "that should not be interpreted as a sign that these are the glory days for
"Out-of-pocket spending is just one component of consumer exposure to health care costs, and they may be facing this exposure through higher premiums, or reduced benefits, or both," he said.
Third-party payers, such as the insurers, not out-of-pocket payers, do most of the actual spending, Lieberthal said.
"That might be something that's surprising to people: how much of the care is coming from a source other than the one receiving the care," Lieberthal said.
Nevertheless, Brennan said consumers are "undoubtedly" affected.
"Somebody's got to pay for this, so I think a lot of the discussion around rising premiums in recent years definitely implicates these price increases and their impact on consumers," he said, adding that many other possible factors, such as increased consolidation in the provider market, could cause price increases, but more research is needed.
The full report calculates spending, prices and utilization for four broad categories -- inpatient, outpatient, professional services and prescription drugs -- before breaking the findings into 35 subcategories.
Lieberthal said the report provides a great resource for understanding the complexities of the nation's health care spending, but cautioned readers that isolated statistics are snapshots of the "full picture."
"It does represent only part of the data for health care spending in
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