Increasing health care spending has been part of the US economy for decades, consuming an ever-increasing share of gross domestic product. However, in the past several years, the growth of US health spending has slowed to well below its historic norm.1 This slowdown in the rate of spending growth predates implementation of the Affordable Care Act.
The causes of the slowdown in the growth of health care spending have been widely debated by researchers and policy makers. Does the slowdown reflect merely short-term effects of the financial crisis of 2007-2009 and subsequent years of slow economic growth? Have changes in the health care system more fundamentally altered the mid- and long-term cost trajectory?2 The implications matter, as a sustained slowdown in health care spending growth would significantly improve the US fiscal outlook.
Periods when the US economy was in recession are shaded. Source: 2013 Organisation for Economic Co-operation and Development (OECD) health data.5 US health spending data are from National Health Expenditure Accounts, adjusted to meet OECD definitions (Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group).aThe OECD median includes only the 23 OECD countries with ≥25 years of data between 1980 and 2011.bIn 2012, data were available only for 12 OECD countries, including the United States.
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