673:(CBO) estimated that the health insurance premium for single coverage would be $ 6,400 and family coverage would be $ 15,500 in 2016. The annual rate of increase in premiums has generally slowed after 2000, as part of the trend of lower annual healthcare cost increases. The Federal Government subsidizes the employer-based market by an estimated $ 250 billion per year (about $ 1,612 per person covered in the employer market), by excluding health insurance premiums from employee income. This subsidy encourages people to buy more extensive coverage (which places upward pressure on average premiums), while also encouraging more young, healthy people to enroll (which places downward pressure on premium prices). CBO estimates the net effect is to increase premiums 10-15% over an un-subsidized level.
834:. About 25% of U.S. healthcare costs relate to administrative costs (e.g., billing and payment, as opposed to direct provision of services, supplies and medicine) versus 10-15% in other countries. For example, Duke University Hospital had 900 hospital beds but 1,300 billing clerks. Assuming $ 3.2 trillion is spent on healthcare per year, a 10% savings would be $ 320 billion per year and a 15% savings would be nearly $ 500 billion per year. For scale, cutting administrative costs to peer country levels would represent roughly one-third to half the gap. A 2009 study from Price Waterhouse Coopers estimated $ 210 billion in savings from unnecessary billing and administrative costs, a figure that would be considerably higher in 2015 dollars.
816:
661:
482:, they do not directly pay for medical services. Insurance companies, as payors, negotiate health care pricing with providers on behalf of the insured. Hospitals, doctors, and other medical providers have traditionally disclosed their fee schedules only to insurance companies and other institutional payors, and not to individual patients. Uninsured individuals are expected to pay directly for services, but since they lack access to pricing information, price-based competition may be reduced. The introduction of high-deductible insurance has increased demand for pricing information among consumers. As high-deductible
392:. Proximate reasons for the differences with other countries include higher prices for the same services (i.e., a higher price per unit) and greater use of healthcare (i.e., more units consumed). Higher administrative costs, higher per-capita income, and less government intervention to drive down prices are deeper causes. While the annual inflation rate in healthcare costs has declined in recent decades, it still remains above the rate of economic growth, resulting in a steady increase in healthcare expenditures relative to GDP from 6% in 1970 to nearly 18% in 2015.
824:
trillion, about $ 3,000 per person relative to the next most expensive country. In other words, the U.S. would have to cut healthcare costs by roughly one-third ($ 1 trillion or $ 3,000 per person on average) to be competitive with the next most expensive country. Healthcare spending in the U.S. was distributed as follows in 2014: Hospital care 32%; physician and clinical services 20%; prescription drugs 10%; and all other, including many categories individually making up less than 5% of spending. These first three categories accounted for 62% of spending.
808:
652:(RVUs) are assigned to every medical procedure. One RVU translates into a dollar value that varies by region and by year; in 2005 the base (not location adjusted) RVU equaled roughly $ 37.90. Major insurers use Medicare's RVU calculations when negotiating payment schedules with providers, and many insurers simply adopt Medicare's payment schedule. The AMA-sponsored committee in charge of determining RVUs of medical procedures that inform Medicare's payment to physicians has been shown to grossly inflate their figures.
426:
323:
645:(CMS). CMS sets fee schedules for medical services through Prospective Payment Systems (PPS) for inpatient care, outpatient care, and other services. As the largest single purchaser of medical services in the U.S., Medicare's fixed pricing schedules have a significant impact on the market. These prices are set based on CMS' analysis of labor and resource input costs for different medical services based on recommendations by the American Medical Association.
876:
eliminate much of the high administrative costs of insurance, obtain lower prices for inputs, and influence the mix of healthcare outputs by arranging for large supplies of primary-care physicians and hospital beds while keeping tight control on the number of specialist physicians and expensive technology. In the United States, the political system creates many “choke points” for diverse interest groups to block or modify government’s role in these areas."
851:. Drugs are more expensive, doctors are paid more, and suppliers charge more for medical equipment than other countries. Journalist Todd Hixon reported on a study that U.S. spending on physicians per person is about five times higher than peer countries, $ 1,600 versus $ 310, as much as 37% of the gap with other countries. This was driven by a greater use of specialist doctors, who charge 3-6 times more in the U.S. than in peer countries.
334:
630:(CBO) reported in October 2017 that adjusted for timing differences, Medicare spending rose by $ 22 billion (4%) in fiscal year 2017, reflecting growth in both the number of beneficiaries and in the average benefit payment. Medicaid spending rose by $ 7 billion (2%) in part because of more persons enrolled due to the
688:(CEA) described how annual cost increases have fallen in the employer market since 2000. Premiums for family coverage grew 5.6% from 2000-2010, but 3.1% from 2010-2016. The total premium plus estimated out-of-pocket costs (i.e., deductibles and co-payments) increased 5.1% from 2000-2010 but 2.4% from 2010-2016.
823:
U.S. healthcare costs in 2015 were 16.9% GDP according to the OECD, over 5% GDP higher than the next most expensive OECD country. With U.S. GDP of $ 19 trillion, healthcare costs were about $ 3.2 trillion, or about $ 10,000 per person in a country of 320 million people. A gap of 5% GDP represents $ 1
711:
For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in
Alabama and 60 percent in Texas. However, some or
574:
or situations where the actions of one person or company positively impact the health of others, such as vaccinations and medical research. The free market will result in too little of both (i.e., the benefit is under-estimated by individuals), so government intervention such as subsidies is required
716:
reported that for the second-lowest cost "Silver plan" (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $ 30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $ 208/month) after the subsidy/tax
707:
in the form of premium tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer.
680:
estimated that family insurance premiums averaged $ 18,142 in 2016, up 3% from 2015, with workers paying $ 5,277 towards that cost and employers covering the remainder. Single coverage premiums were essentially unchanged from 2015 to 2016 at $ 6,435, with workers contributing $ 1,129 and employers
486:
rise across the country, with many individuals having deductibles of $ 2500 or more, their ability to pay for costly procedures diminishes, and hospitals end up covering the cost of patients care. Many health systems are putting in place price transparency initiatives and payments plans for their
844:
reported in 2013 that roughly 33% of healthcare spending, or about $ 1 trillion per year, is not associated with improved outcomes. Medicare reimbursements per enrollee vary significantly across the country. In 2012, average
Medicare reimbursements per enrollee ranged from an adjusted (for health
553:
This government mandated care places a cost burden on medical providers, as critically ill patients lacking financial resources must be treated. Medical providers compensate for this cost by passing costs on to other parts of the medical system by increasing prices for other patients and through
889:
analyzed the reasons for healthcare cost inflation over time, reporting in 2008 that: "Although many factors contributed to the growth, most analysts have concluded that the bulk of the long-term rise resulted from the health care system's use of new medical services that were made possible by
875:
in the United States than in other countries. Stanford economist Victor Fuchs wrote in 2014: "If we turn the question around and ask why healthcare costs so much less in other high-income countries, the answer nearly always points to a larger, stronger role for government. Governments usually
416:
program. The 272 million non-institutional persons under age 65 either obtained their coverage from employer-based (155 million) or non-employer based (90 million) sources or were uninsured (27 million). Approximately 15 million military personnel received coverage through the
Veteran's
634:. Unadjusted for timing shifts, in 2017 Medicare spending was $ 595 billion and Medicaid spending was $ 375 billion. Medicare covered 57 million people as of September 2016. While on the other hand, Medicaid covered 68.4 million people as of July 2017, 74.3 million including the
474:
found that only 25% of visitors asking for pricing information were able to obtain it in a single visit to a hospital. This has led to a phenomenon known as "surprise medical bills", where patients receive large bills for service long after the service was rendered.
586:
Adverse selection, where insurers can choose to avoid sick patients. This can lead to a "death spiral" in which the healthiest people drop out of insurance coverage perceiving it too expensive, leading to higher prices for the remainder, repeating the cycle.
868:
than people in other countries. The U.S. consumes 3 times as many mammograms, 2.5x the number of MRI scans, and 31% more C-sections per-capita than peer countries. This is a blend of higher per-capita income and higher use of specialists, among other
578:
Consumers don't know what to buy, as the technical nature of the product requires expert physician advice. The inability to monitor product quality leads to regulation (e.g., licensing of medical professionals and the safety of pharmaceutical
451:. Patients are typically not able to comparison shop for medical services based on price, as medical service providers do not typically disclose prices prior to service. Government mandated critical care and government insurance programs like
411:
Health insurance coverage is provided by several public and private sources in the United States. During 2016, the U.S. population overall was approximately 325 million, with 53 million persons 65 years of age and older covered by the federal
2027:
861:
that concluded about $ 1,200 per person (in 2008 dollars) or about a third of the gap with peer countries in healthcare spending was due to higher levels of per-capita income. Higher income per-capita is correlated with using more units of
506:
has called for transparency in the prices of medical devices, noting it is one of the few aspects or U.S. health care where consumers and federal health officials are "barred from comparing the quality, medical outcomes or price".
582:
Healthcare spending is unpredictable and expensive. This results in insurance to pool risks and reduce uncertainty. However, this creates a side-effect, the decreased visibility of spending and a tendency to over-consume medical
545:
In the United States and most other industrialized nations, emergency medical providers are required to treat any patient that has a life-threatening condition, irrespective of the patient's financial resources. In the U.S., the
664:
The rate of increase in both health insurance premiums and out-of-pocket costs have declined in the employer-based market. For example, premiums increased at an annual rate of 5.6% from 2000-2010, but 3.1% from
510:
Recently, some insurance companies have announced their intention to begin disclosing provider pricing as a way to encourage cost reduction. Other services exist to assist physicians and their patients, such as
927:
While this inflation rate has declined, it has generally remained above the rate of economic growth, resulting in a steady increase of health expenditures relative to GDP from 6% in 1970 to nearly 18% in 2015.
702:
Separate from the employer market are the ACA marketplaces, which covered an estimated 12 million persons in 2017 who individually obtain insurance (e.g., not as part of a business). The law is designed to pay
724:
discontinued in 2017 by
President Donald Trump, an action which raised premiums in the ACA marketplaces by an estimated 20 percentage points above what otherwise would have occurred, for the 2018 plan year.
790:
According to the OECD, U.S. prescription drug spending in 2015 was $ 1,162 per person on average, versus $ 807 for Canada, $ 766 for
Germany, $ 668 for France, and is capped in the UK at ÂŁ105.90($ 132)
717:
credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases.
1606:
1693:
1343:
1197:
The perils of transparent pricing: the time for speculation is over: transparent pricing is becoming a reality for hospitals. | Health Care > Health Care
Professionals from AllBusiness.com
264:
819:
Though the U.S. healthcare system tends to produce more innovation, it has a lower level of regulation, and almost every form of its healthcare costs more than other high-income countries.
890:
technological advances..." In summarizing several studies, CBO reported the following drove the indicated share (shown as a range across three studies) of the increase from 1940 to 1990:
1776:
758:
The percentage of workers with a deductible of at least $ 1,000 grew from 10% in 2006 to 51% in 2016. The 2016 figure drops to 38% after taking employer contributions into account.
1814:
772:
While about 75% of enrollees were "very satisfied" or "somewhat satisfied" with their choice of doctors and hospitals, only 50% had such satisfaction with their annual deductible.
362:
595:, advocated individual mandates in the late 1980s to overcome adverse selection by requiring all persons to obtain insurance or pay penalties, an idea ultimately included in the
211:
100:
498:
support a "fair and accurate valuation for all physician services". Very few resources exist, however, that allow consumers to compare physician prices. The AMA sponsors the
201:
894:
Technology changes: 38-65%. CBO defined this as "any changes in clinical practice that enhance the ability of providers to diagnose, treat, or prevent health problems."
512:
206:
1440:
1318:
499:
1486:
459:
in 2011, "the United States is far and away the world leader in medical spending, even though numerous studies have concluded that
Americans do not get better
1610:
537:
According to the estimation of the US government, hundreds of thousands of
Americans (Californians ) traveled to Mexico annually to get healthcare services.
417:
Administration. During the year 2016, 91.2% of
Americans had health insurance coverage. An estimated 27 million people under the age of 65 were uninsured.
355:
181:
1060:
94:
2038:
1631:
125:
55:
733:
While health insurance premium cost increases have moderated in the employer market, some of this is because of insurance policies that have a higher
1170:
755:
In 2016, 4 in 5 workers had an insurance deductible, which averaged $ 1,478. For firms with less than 200 employees, the deductible averaged $ 2,069.
547:
487:
patients so that the patients better understand what the estimated cost of their care is, and how they can afford to pay for their care over time.
88:
502:, a private group of physicians which largely determine how to value physician labor in Medicare prices. Among politicians, former House Speaker
384:
Compared to other OECD countries, U.S. healthcare costs are one-third higher or more relative to the size of the economy (GDP). According to the
348:
381:
describe market and non-market factors that determine pricing, along with possible causes as to why prices are higher than in other countries.
623:
was established at the same time to provide medical insurance primarily to children, pregnant women, and certain other medically needy groups.
406:
221:
1903:
967:
785:
60:
2032:
1885:
1263:
470:, patients generally do not have access to pricing information until after medical services have been rendered. A study conducted by the
1950:
697:
642:
550:
requires that hospitals treat all patients in need of emergency medical care without considering patients' ability to pay for service.
385:
175:
106:
1516:
1936:
1915:
Physicians for a
National Health Program-Beyond the ACA: A Physicians Proposal for Single Payer Healthcare-Retrieved October 25, 2017
962:
857:, which is correlated with higher healthcare spending in the U.S. and other countries. Hixon reported a study by Princeton Professor
669:
An estimated 155 million persons under the age 65 were covered under health insurance plans provided by their employers in 2016. The
388:, during 2015, health expenditures per-person were nearly $ 10,000 on average, with total expenditures of $ 3.2 trillion or 17.8% of
216:
1742:
1839:
952:
520:
1137:
1755:
903:
Aging of the population: 2%. As the country ages, more persons require more expensive treatments, as the aged tend to be sicker.
775:
While 52% of those covered by the ACA exchanges felt "well protected" by their insurance, in the group market 63% felt that way.
635:
119:
42:
1990:
1937:
Hamilton Project-Six Economic Facts About Health Care and Health Insurance Markets after the Affordable Care Act-October 2015
741:
and out-of-pocket maximums that shift costs from insurers to patients. In addition, many employees are choosing to combine a
2071:
566:
explained in July 2017 that "the magic of the free market sometimes fails us when it comes to healthcare." This is due to:
1572:
1322:
81:
17:
1665:
972:
519:, with its CarePricer software. Similarly, medical tourists take advantage of price transparency on websites such as
1537:
762:
For the "non-group" market, of which two-thirds are covered by the ACA exchanges, a survey of 2015 data found that:
2002:
937:
471:
162:
144:
721:
131:
815:
799:
The reasons for higher U.S. healthcare costs relative to other countries and over time are debated by experts.
1731:
1864:
2044:
997:
1214:"Higher Fees Paid To US Physicians Drive Higher Spending For Physician Services Compared To Other Countries"
1777:"2017 Premium Changes and Insurer Participation in the Affordable Care Act's Health Insurance Marketplaces"
1289:
685:
660:
527:
491:
897:
Personal income growth: 5-23%. Persons with more income tend to spend a greater share of it on healthcare.
2076:
1196:
1171:"The $ 2.7 Trillion Medical Bill - Colonoscopies Explain Why U.S. Leads the World in Health Expenditures"
886:
670:
627:
516:
254:
1583:
752:
Deductibles grew by 63% from 2011 to 2016, while premiums increased 19% and worker earnings grew by 11%.
748:
For those who obtain their insurance through their employer ("group market"), a 2016 survey found that:
2017:
1561:
907:
According to Federal Reserve data, healthcare annual inflation rates have declined in recent decades:
2066:
1112:
1100:
942:
249:
244:
1061:
The Atlantic-Victor Fuchs-Why Do Other Rich Nations Spend So Much Less on Healthcare?"-July 23, 2014
677:
608:
452:
413:
259:
1388:
1562:
Analysis of the Joint Distribution of Disproportionate Share Hospital Payments: Executive Summary
588:
299:
1365:
845:
status, income, and ethnicity) $ 6,724 in the lowest spending region to $ 13,596 in the highest.
1980:
1925:
1877:
1267:
769:
Many marketplace enrollees qualify for cost-sharing subsidies that reduce their net deductible.
742:
389:
294:
239:
34:
1632:
Medicaid.gov July 2017 Medicaid and CHIP Enrollment Data Highlights-Retrieved October 27, 2017
1213:
1101:
Census Bureau-Health Insurance Coverage in the United States: 2015 - Published September, 2016
1904:
PBS-Why Does Healthcare Cost So Much in America? Ask Harvard's David Cutler-November 19, 2013
766:
49% had individual deductibles of at least $ 1,500 ($ 3,000 for family), up from 36% in 2014.
745:
with higher deductible plans, making the impact of the ACA difficult to determine precisely.
442:
276:
156:
1655:
1044:
649:
327:
271:
150:
429:
U.S. healthcare cost information, including rate of change, per-capita, and percent of GDP
8:
631:
596:
438:
2049:
1997:
1175:
1142:
1002:
947:
807:
456:
338:
1802:"CBO: The Effects of Terminating Payments for Cost-Sharing Reductions"-August 15, 2017
1301:
1986:
1680:
1661:
1233:
1027:
OECD Statistical Database-Health expenditure and financing-Retrieved October 25, 2017
713:
616:
563:
1498:
1297:
1225:
1026:
592:
479:
467:
712:
all of these costs are offset by subsidies, paid as tax credits. For example, the
1982:
The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care
531:
448:
304:
1074:
1962:
CBO-Technological Change and the Growth of Healthcare Spending-January 31, 2008
1475:
612:
309:
1229:
425:
2060:
957:
858:
571:
503:
434:
377:
2022:
1642:
1237:
1209:
977:
841:
445:
1815:"How companies are quietly changing your health plan to make you pay more"
1414:
534:, which offer hospital price comparison and appointment booking services.
1541:
1088:"Federal Subsidies for Health Insurance Coverage for People Under Age 65"
483:
460:
1961:
1801:
1720:
1594:
1288:
Schulman, Kevin A.; Milstein, Arnold; Richman, Barak D. (10 July 2019).
1087:
998:"Hospitals and Insurers Didn't Want You to See These Prices. Here's Why"
1976:
734:
1951:
Forbes-Todd Hixon-Why are U.S. healthcare costs so high?-March 1, 2012
1721:
CBO-Private Health Insurance Premiums and Federal Policy-February 2016
2045:
Medical Prices may be much higher with health insurance than without?
1573:
NYT-N. Gregory Mankiw-Why Health Care Policy is So Hard-July 28, 2017
1389:"With Health Care, Taxpayers Deserve To Know What They're Paying For"
811:
Comparing healthcare costs as percentage of GDP across OECD countries
738:
1045:
CDC-National Center for Health Statistics-Retrieved October 26, 2017
1660:. Cambridge, Massachusetts: Harvard University Press. p. 288.
620:
1607:"CMS.gov Medicare enrollment dashboard-Retrieved October 27, 2017"
873:
The U.S. government intervenes less actively to force down prices
704:
455:
also impact the market pricing of U.S. health care. According to
1914:
1075:"Federal Reserve Data FRED-CPI All Urban Consumer: Medical Care"
1743:
CEA-Economic Report of the President 2017-Chapter 8-Figure 4-34
1926:
Dr. James E. Dalen-The American Journal of Medicine-March 2010
1732:
Kaiser-2016 Employer Health Benefits Survey-September 14, 2016
641:
Medicare and Medicaid are managed at the Federal level by the
524:
849:
The U.S. spends more than other countries for the same things
1595:
CBO-Monthly Budget Review for September 2017-October 6, 2017
1441:"Newt Gingrich Backs Price Transparency for Medical Devices"
1694:"How a secretive panel uses data that distort doctors' pay"
495:
1691:
1386:
1264:"Price Check: The Mystery of Hospital Pricing - CHCF.org"
691:
1865:
OECD Data-Pharmaceutical spending-Retrieved May 15, 2018
1840:"Survey of Non-Group Health Insurance Enrollees, Wave 3"
2035:(California HealthCare Foundation study, December 2005)
2018:
Dept. of HHS Report on Govt. Payments for Indigent Care
1584:
NYT-Paul Krugman-Heritage on Health, 1989-July 30, 2017
1287:
500:
Specialty Society Relative Value Scale Update Committee
1681:
AMA (RBRVS) RBRVS: Resource-Based Relative Value Scale
1464:
1415:"Gingrich calls for medical device price transparency"
1250:
1113:"Health Insurance Coverage in the United States: 2016"
720:
This premium tax credit subsidy is separate from the
619:
for the elderly (age 65 and above) and the disabled.
557:
540:
27:
Market and non-market factors that determine pricing
395:
1756:"Next president faces possible ObamaCare meltdown"
1725:
1313:
1311:
433:Unlike most markets for consumer services in the
2058:
1869:
1716:
1714:
1499:"Search launched for Americans seized in Mexico"
1412:
548:Emergency Medical Treatment and Active Labor Act
1769:
1476:Patient Estimates – Accuro Healthcare Solutions
1164:
1162:
1160:
1692:Peter Whoriskey; Dan Keating (July 20, 2013).
1657:Fixing Medical Prices: How Physicians are Paid
1387:Newt Gingrich; Wayne Oliver (April 19, 2011).
1308:
1131:
1129:
1080:
802:
407:Health insurance coverage in the United States
1711:
1517:"TRENDS IN U.S. HEALTH TRAVEL SERVICES TRADE"
1207:
968:Healthcare reform debate in the United States
786:Prescription drug prices in the United States
356:
2039:Medical Costs Vary Wildly Around The Country
2033:Price Check: The Mystery of Hospital Pricing
1344:"RBRVS: Resource-Based Relative Value Scale"
1157:
996:Kliff, Sarah; Katz, Josh (August 22, 2021).
420:
182:Health Care and Education Reconciliation Act
1366:"AARP: Creating a New Health Care Paradigm"
1138:"Revealing a Health Care Secret: The Price"
1126:
1056:
1054:
1052:
989:
794:
478:Since the majority (85%) of Americans have
463:" and prices are the highest in the world.
2023:Centers for Medicare and Medicaid Services
1899:
1897:
1895:
1813:Johnson, Carolyn Y. (September 14, 2016).
1438:
880:
698:Patient Protection and Affordable Care Act
643:Centers for Medicare and Medicaid Services
363:
349:
1946:
1944:
1875:
1168:
1135:
995:
963:Healthcare rationing in the United States
1846:. Kaiser Family Foundation. May 20, 2016
1795:
1736:
1653:
1049:
953:Health care finance in the United States
814:
806:
659:
655:
611:was established in 1965 under President
603:
424:
1892:
1878:"Big Profits in Caring for the Elderly"
1812:
1566:
1070:
1068:
1022:
1020:
14:
2059:
2041:(state-by-state and intrastate charts)
1941:
1919:
1888:from the original on December 4, 2023.
1040:
1038:
1036:
1034:
838:Cost variation across hospital regions
692:Affordable Care Act (ACA) marketplaces
648:As part of Medicare's pricing system,
1876:Leonhardt, David (December 4, 2023).
1169:Rosenthal, Elisabeth (June 2, 2013).
779:
1975:
1754:Mali, Meghashyam (August 11, 2016).
1753:
1747:
1065:
1017:
554:collection of government subsidies.
1031:
866:Americans receive more medical care
636:Children's Health Insurance Program
126:America's Affordable Health Choices
24:
1969:
1290:"Resolving Surprise Medical Bills"
558:Healthcare is not a typical market
120:Affordable Health Care for America
82:Social Security Amendments of 1965
25:
2088:
2011:
1302:10.1377/forefront.20190628.873493
1136:Rosenberg, Tina (July 31, 2013).
973:Medical debt in the United States
855:Higher level of per-capita income
541:Government-mandated critical care
1413:Brendon Nafziger (May 2, 2011).
1253:California Healthcare Foundation
938:American Health Care Act of 2017
472:California Healthcare Foundation
396:Nature of the healthcare markets
332:
321:
1985:. New York: The Penguin Press.
1955:
1930:
1908:
1858:
1832:
1806:
1685:
1674:
1647:
1636:
1625:
1599:
1588:
1577:
1555:
1530:
1509:
1491:
1480:
1469:
1458:
1432:
1406:
1380:
1358:
1336:
1281:
1256:
1244:
1201:
1190:
827:Important differences include:
722:cost sharing reductions subsidy
591:, a conservative think tank in
575:to optimize the market outcome.
1346:. American Medical Association
1105:
1094:
728:
202:Obama administration proposals
13:
1:
1077:. Retrieved October 26, 2017.
983:
1654:Laugesen, Miriam J. (2016).
1319:"U.S. Census Press Releases"
900:Administrative costs: 3-13%.
686:Council of Economic Advisors
492:American Medical Association
7:
2072:Social problems in medicine
931:
887:Congressional Budget Office
803:Relative to other countries
671:Congressional Budget Office
628:Congressional Budget Office
517:Accuro Healthcare Solutions
400:
10:
2093:
1487:Patient Estimates – MEDIGO
1439:Leigh Page (May 3, 2011).
783:
695:
490:Organizations such as the
404:
376:Health care prices in the
289:Third-party payment models
101:Medicare Modernization Act
1465:Compare Provider Chargers
1230:10.1377/hlthaff.2010.0204
943:Charge description master
421:Price transparency issues
245:Health insurance exchange
2028:AMA Description of RBRVS
1781:Kaiser Family Foundation
1294:Health Affairs Forefront
795:Reasons for higher costs
681:covering the remainder.
678:Kaiser Family Foundation
513:Healthcare Out Of Pocket
378:United States of America
328:United States portal
145:American Health Care Act
44:Healthcare reform in the
33:This article is part of
881:Relative to prior years
589:The Heritage Foundation
441:market generally lacks
1090:. CBO. March 24, 2016.
820:
812:
743:health savings account
666:
430:
339:Health care portal
295:All-payer rate setting
250:Nationalized insurance
212:Reform advocacy groups
2003:registration required
1208:Laugesen, Miriam J.;
818:
810:
663:
656:Employer-based market
604:Medicare and Medicaid
428:
405:Further information:
265:Canadian vs. American
157:Healthy Americans Act
840:. Harvard economist
832:Administrative costs
650:relative value units
151:Medicare for All Act
1698:The Washington Post
1613:on October 16, 2019
1538:"EM Topics: EMTALA"
1445:Becker's ASC Review
1251:http://www.chcf.org
632:Affordable Care Act
597:Affordable Care Act
570:Important positive
176:Affordable Care Act
163:Health Security Act
2077:Waste of resources
2053:, August 22, 2021)
2050:The New York Times
1882:The New York Times
1212:(September 2011).
1176:The New York Times
1143:The New York Times
1115:. US Census Bureau
1003:The New York Times
948:Financial toxicity
821:
813:
780:Prescription drugs
667:
562:Harvard economist
530:2017-10-20 at the
457:The New York Times
431:
222:Insurance coverage
132:Baucus Health Bill
18:Health care prices
1992:978-1-59420-234-6
714:Kaiser Foundation
617:medical insurance
564:N. Gregory Mankiw
525:Purchasing Health
373:
372:
153:(2021, H.R. 1976)
47:
16:(Redirected from
2084:
2067:Health economics
2006:
1996:
1964:
1959:
1953:
1948:
1939:
1934:
1928:
1923:
1917:
1912:
1906:
1901:
1890:
1889:
1873:
1867:
1862:
1856:
1855:
1853:
1851:
1836:
1830:
1829:
1827:
1825:
1810:
1804:
1799:
1793:
1792:
1790:
1788:
1773:
1767:
1766:
1764:
1762:
1751:
1745:
1740:
1734:
1729:
1723:
1718:
1709:
1708:
1706:
1704:
1689:
1683:
1678:
1672:
1671:
1651:
1645:
1640:
1634:
1629:
1623:
1622:
1620:
1618:
1609:. Archived from
1603:
1597:
1592:
1586:
1581:
1575:
1570:
1564:
1559:
1553:
1552:
1550:
1549:
1540:. Archived from
1534:
1528:
1527:
1521:
1513:
1507:
1506:
1495:
1489:
1484:
1478:
1473:
1467:
1462:
1456:
1455:
1453:
1451:
1436:
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1429:
1427:
1425:
1410:
1404:
1403:
1401:
1399:
1384:
1378:
1377:
1375:
1373:
1362:
1356:
1355:
1353:
1351:
1340:
1334:
1333:
1331:
1330:
1321:. Archived from
1315:
1306:
1305:
1285:
1279:
1278:
1276:
1275:
1266:. Archived from
1260:
1254:
1248:
1242:
1241:
1224:(9): 1647–1656.
1210:Glied, Sherry A.
1205:
1199:
1194:
1188:
1187:
1185:
1183:
1166:
1155:
1154:
1152:
1150:
1133:
1124:
1123:
1121:
1120:
1109:
1103:
1098:
1092:
1091:
1084:
1078:
1072:
1063:
1058:
1047:
1042:
1029:
1024:
1015:
1014:
1012:
1010:
993:
684:The President's
593:Washington, D.C.
480:health insurance
468:medical industry
365:
358:
351:
337:
336:
335:
326:
325:
324:
43:
30:
29:
21:
2092:
2091:
2087:
2086:
2085:
2083:
2082:
2081:
2057:
2056:
2014:
2000:
1993:
1972:
1970:Further reading
1967:
1960:
1956:
1949:
1942:
1935:
1931:
1924:
1920:
1913:
1909:
1902:
1893:
1874:
1870:
1863:
1859:
1849:
1847:
1838:
1837:
1833:
1823:
1821:
1819:Washington Post
1811:
1807:
1800:
1796:
1786:
1784:
1783:. November 2016
1775:
1774:
1770:
1760:
1758:
1752:
1748:
1741:
1737:
1730:
1726:
1719:
1712:
1702:
1700:
1690:
1686:
1679:
1675:
1668:
1652:
1648:
1641:
1637:
1630:
1626:
1616:
1614:
1605:
1604:
1600:
1593:
1589:
1582:
1578:
1571:
1567:
1560:
1556:
1547:
1545:
1536:
1535:
1531:
1519:
1515:
1514:
1510:
1497:
1496:
1492:
1485:
1481:
1474:
1470:
1463:
1459:
1449:
1447:
1437:
1433:
1423:
1421:
1411:
1407:
1397:
1395:
1385:
1381:
1371:
1369:
1364:
1363:
1359:
1349:
1347:
1342:
1341:
1337:
1328:
1326:
1317:
1316:
1309:
1286:
1282:
1273:
1271:
1262:
1261:
1257:
1249:
1245:
1206:
1202:
1195:
1191:
1181:
1179:
1167:
1158:
1148:
1146:
1134:
1127:
1118:
1116:
1111:
1110:
1106:
1099:
1095:
1086:
1085:
1081:
1073:
1066:
1059:
1050:
1043:
1032:
1025:
1018:
1008:
1006:
994:
990:
986:
934:
923:2010–2016: 3.0%
920:2000–2009: 4.1%
917:1990–1999: 5.3%
914:1980–1989: 8.3%
911:1970–1979: 7.8%
883:
805:
797:
788:
782:
731:
700:
694:
658:
615:, as a form of
606:
560:
543:
532:Wayback Machine
423:
409:
403:
398:
369:
333:
331:
330:
322:
320:
315:
314:
305:Fee-for-service
290:
282:
281:
255:Publicly-funded
235:
227:
226:
197:
189:
188:
184:
72:
45:
28:
23:
22:
15:
12:
11:
5:
2090:
2080:
2079:
2074:
2069:
2055:
2054:
2042:
2036:
2030:
2025:
2020:
2013:
2012:External links
2010:
2009:
2008:
1991:
1971:
1968:
1966:
1965:
1954:
1940:
1929:
1918:
1907:
1891:
1868:
1857:
1831:
1805:
1794:
1768:
1746:
1735:
1724:
1710:
1684:
1673:
1666:
1646:
1635:
1624:
1598:
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1479:
1468:
1457:
1431:
1405:
1379:
1357:
1335:
1307:
1280:
1255:
1243:
1218:Health Affairs
1200:
1189:
1156:
1125:
1104:
1093:
1079:
1064:
1048:
1030:
1016:
987:
985:
982:
981:
980:
975:
970:
965:
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945:
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933:
930:
925:
924:
921:
918:
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905:
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898:
895:
882:
879:
878:
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870:
863:
852:
846:
835:
804:
801:
796:
793:
784:Main article:
781:
778:
777:
776:
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770:
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730:
727:
696:Main article:
693:
690:
657:
654:
613:Lyndon Johnson
605:
602:
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584:
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353:
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342:
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317:
316:
313:
312:
310:Global payment
307:
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297:
291:
288:
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269:
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207:Public opinion
204:
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179:
172:
171:
170:Latest enacted
167:
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39:
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26:
9:
6:
4:
3:
2:
2089:
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2062:
2052:
2051:
2046:
2043:
2040:
2037:
2034:
2031:
2029:
2026:
2024:
2021:
2019:
2016:
2015:
2004:
1999:
1994:
1988:
1984:
1983:
1978:
1974:
1973:
1963:
1958:
1952:
1947:
1945:
1938:
1933:
1927:
1922:
1916:
1911:
1905:
1900:
1898:
1896:
1887:
1883:
1879:
1872:
1866:
1861:
1850:September 14,
1845:
1841:
1835:
1824:September 14,
1820:
1816:
1809:
1803:
1798:
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1688:
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1669:
1667:9780674545168
1663:
1659:
1658:
1650:
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1628:
1612:
1608:
1602:
1596:
1591:
1585:
1580:
1574:
1569:
1563:
1558:
1544:on 2006-02-11
1543:
1539:
1533:
1525:
1518:
1512:
1504:
1500:
1494:
1488:
1483:
1477:
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1466:
1461:
1446:
1442:
1435:
1420:
1416:
1409:
1394:
1390:
1383:
1367:
1361:
1345:
1339:
1325:on 2006-06-27
1324:
1320:
1314:
1312:
1303:
1299:
1295:
1291:
1284:
1270:on 2006-05-14
1269:
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1239:
1235:
1231:
1227:
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1219:
1215:
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1071:
1069:
1062:
1057:
1055:
1053:
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1041:
1039:
1037:
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1028:
1023:
1021:
1005:
1004:
999:
992:
988:
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974:
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969:
966:
964:
961:
959:
958:Health system
956:
954:
951:
949:
946:
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936:
935:
929:
922:
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910:
909:
908:
902:
899:
896:
893:
892:
891:
888:
874:
871:
867:
864:
860:
859:Uwe Reinhardt
856:
853:
850:
847:
843:
839:
836:
833:
830:
829:
828:
825:
817:
809:
800:
792:
787:
774:
771:
768:
765:
764:
763:
757:
754:
751:
750:
749:
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744:
740:
736:
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723:
718:
715:
709:
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689:
687:
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672:
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644:
639:
637:
633:
629:
624:
622:
618:
614:
610:
598:
594:
590:
585:
581:
577:
573:
572:externalities
569:
568:
567:
565:
555:
551:
549:
538:
535:
533:
529:
526:
522:
518:
514:
508:
505:
504:Newt Gingrich
501:
497:
493:
488:
485:
481:
476:
473:
469:
464:
462:
458:
454:
450:
447:
444:
440:
436:
435:United States
427:
418:
415:
408:
393:
391:
387:
382:
380:
379:
366:
361:
359:
354:
352:
347:
346:
344:
343:
340:
329:
319:
318:
311:
308:
306:
303:
301:
298:
296:
293:
292:
286:
285:
278:
275:
273:
270:
266:
263:
262:
261:
258:
256:
253:
251:
248:
246:
243:
241:
238:
237:
231:
230:
223:
220:
218:
215:
213:
210:
208:
205:
203:
200:
199:
193:
192:
183:
180:
177:
174:
173:
169:
168:
164:
161:
158:
155:
152:
149:
146:
143:
142:
138:
137:
133:
130:
127:
124:
121:
118:
117:
113:
112:
108:
105:
102:
99:
96:
93:
90:
87:
86:
83:
80:
79:
75:
74:
68:
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62:
59:
57:
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53:
52:
51:
48:
46:United States
41:
40:
36:
32:
31:
19:
2048:
1981:
1957:
1932:
1921:
1910:
1881:
1871:
1860:
1848:. Retrieved
1843:
1834:
1822:. Retrieved
1818:
1808:
1797:
1787:November 23,
1785:. Retrieved
1780:
1771:
1759:. Retrieved
1749:
1738:
1727:
1701:. Retrieved
1697:
1687:
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1638:
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1615:. Retrieved
1611:the original
1601:
1590:
1579:
1568:
1557:
1546:. Retrieved
1542:the original
1532:
1523:
1511:
1502:
1493:
1482:
1471:
1460:
1448:. Retrieved
1444:
1434:
1422:. Retrieved
1418:
1408:
1396:. Retrieved
1392:
1382:
1370:. Retrieved
1360:
1348:. Retrieved
1338:
1327:. Retrieved
1323:the original
1293:
1283:
1272:. Retrieved
1268:the original
1258:
1246:
1221:
1217:
1203:
1192:
1180:. Retrieved
1174:
1147:. Retrieved
1141:
1117:. Retrieved
1107:
1096:
1082:
1007:. Retrieved
1001:
991:
978:Medical debt
926:
906:
884:
872:
865:
854:
848:
842:David Cutler
837:
831:
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822:
798:
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710:
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683:
675:
668:
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640:
625:
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552:
544:
536:
509:
489:
484:health plans
477:
466:In the U.S.
465:
446:market-based
432:
410:
383:
375:
374:
260:Single-payer
159:(2007, 2009)
1977:Reid, T. R.
1617:October 27,
862:healthcare.
739:co-payments
729:Deductibles
443:transparent
240:Free market
185:(H.R. 4872)
178:(H.R. 3590)
165:(H.R. 3600)
128:(H.R. 3200)
122:(H.R. 3962)
71:Legislation
2061:Categories
1761:August 15,
1548:2006-02-15
1393:Forbes.com
1329:2017-12-05
1274:2006-02-15
1119:2017-10-11
1009:August 22,
984:References
735:deductible
665:2010-2016.
579:products).
494:(AMA) and
439:healthcare
300:Capitation
114:Superseded
1703:March 23,
1524:usitc.gov
1182:August 1,
1149:August 1,
705:subsidies
277:Universal
217:Rationing
134:(S. 1796)
76:Preceding
1979:(2009).
1886:Archived
1643:Medicare
1296:(Blog).
1238:21900654
932:See also
869:factors.
638:(CHIP).
621:Medicaid
609:Medicare
528:Archived
453:Medicare
414:Medicare
401:Coverage
272:Two-tier
139:Proposed
35:a series
1844:kff.org
449:pricing
234:Systems
196:Reforms
56:History
1998:Online
1989:
1664:
1450:May 3,
1424:May 3,
1419:DotMed
1398:May 3,
1372:May 3,
1368:. AARP
1350:May 3,
1236:
521:MEDIGO
437:, the
147:(2017)
109:(2005)
103:(2003)
97:(1996)
91:(1986)
89:EMTALA
61:Debate
1520:(PDF)
583:care.
107:PSQIA
95:HIPAA
1987:ISBN
1852:2016
1826:2016
1789:2016
1763:2016
1705:2014
1662:ISBN
1619:2017
1452:2011
1426:2011
1400:2011
1374:2011
1352:2011
1234:PMID
1184:2013
1151:2013
1011:2021
885:The
676:The
626:The
523:and
496:AARP
461:care
1503:BCC
1298:doi
1226:doi
515:,
390:GDP
386:CDC
2063::
1943:^
1894:^
1884:.
1880:.
1842:.
1817:.
1779:.
1713:^
1696:.
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1310:^
1292:.
1232:.
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1000:.
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37:on
2047:(
2007:.
2005:)
2001:(
1995:.
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1828:.
1791:.
1765:.
1707:.
1670:.
1621:.
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1526:.
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1376:.
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1277:.
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364:e
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