Health care accounts for 16% of the country’s gross domestic product, the highest among the world’s industrialized nations. Over the past decade, the pace of total health care spending has grown faster than inflation and the growth in national income. The combination of the significant portion of the nation’s spending on health care along with the rapid growth in spending have grabbed the attention of the nation’s policy makers, as well as patients, providers, employers, and payors. Although Americans benefit from many of the investments in health care, the recent rapid cost growth, coupled with an overall economic downturn has placed great strains on the systems used to finance health care, including private employer-sponsored health insurance coverage and public insurance programs. Government programs, such as Medicare and Medicaid, account for a significant share of health care spending, but they have increased at a slower rate than private insurance, which have risen dramatically over the past two decades. At the same time, consumers have seen their out-of-pocket costs for deductibles, copayments, and other expenses rise significantly over the same period.
The growth in costs has raised many questions, including what factors drive the rise in costs, how to best curb the rate of increase in costs, and whether higher spending has resulted in commensurate delivery of care. These questions and others are explored in the materials in this section.