The Distribution of Public Spending for Health Care in the United States on the Eve of Health Reform

The intensity of the opposition to health reform in the United States continues to shock and perplex proponents of the Patient Protection and Affordable Care Act (PPACA). The emotion (“Abort Obama”) and the apocalyptic rhetoric (“Save our Country, Protect our Liberty, Repeal Obamacare”), render civil and evidence-based debate over the implications and alternatives to specific provisions in the law difficult if not problematic. The public debate has largely barreled down two non-parallel yet non-intersecting paths: opponents focus on their fear of government expansion in the future if PPACA is implemented now, while proponents focus on the urgency and specifics of our health care market problems and the limited number of tools we have to address them. Frustration on both sides has led opponents to deny the seriousness of our health system’s problems and proponents to ignore the risk of governmental overreach. These non-intersecting lines of argument are not moving us closer to a desired and necessary resolution.

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The Distribution Of Public Spending For Health Care In The United States, 2002

Health Affairs ◽

10.1377/hlthaff.27.5.w349 ◽

2008 ◽

Vol 27 (Suppl1) ◽

pp. w349-w359 ◽

Cited By ~ 17

Author(s):

Thomas M. Selden ◽

Merrile Sing

Keyword(s):

United States ◽

Health Care ◽

Public Spending ◽

The United States

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Private Gain and Public Pain: Financing American Health Care

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2008.00318.x ◽

2008 ◽

Vol 36 (4) ◽

pp. 644-651 ◽

Cited By ~ 2

Author(s):

Bruce Siegel ◽

Holly Mead ◽

Robert Burke

Keyword(s):

United States ◽

Health Care ◽

Health Professionals ◽

Health Reform ◽

Health Care Expenditure ◽

Health Care Expenditures ◽

The United States ◽

Expenditure Patterns ◽

United States Economy ◽

American Health Care

Virtually all Americans are part of the health care system. They may be patients, health professionals, employers providing benefits, insurers, medical manufacturers, regulators, innovators, or investors. Each has a stake in this burgeoning sector of the United States economy, and each may be critically affected, in multiple and diverse ways, by changes to the system under health reform. As health care expenditures continue to rise, it is increasingly important to understand where these expenditures go and the factors that drive these cost increases. This article examines health care expenditure patterns, considering both the “usual suspects” that frequently are cited as spending drivers, as well as certain significant dynamics that may be the main contributors to rising costs. We conclude that in order to successfully contain costs, health reform will need to address these underlying factors.

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