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Lecture 2: The Size of the Medical Care Market

ECON 850 Health Economics Gilleskie. Lecture 2: The Size of the Medical Care Market. Sources: http://www.cms.hhs.gov/NationalHealthExpendData/ http://bea.gov/index.htm http://www.meps.ahrq.gov/mepsweb/data_files/publications http://www.cdc.gov/nchs/ http://nces.ed.gov

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Lecture 2: The Size of the Medical Care Market

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  1. ECON 850 Health Economics Gilleskie Lecture 2: The Size of the Medical Care Market Sources: http://www.cms.hhs.gov/NationalHealthExpendData/ http://bea.gov/index.htm http://www.meps.ahrq.gov/mepsweb/data_files/publications http://www.cdc.gov/nchs/ http://nces.ed.gov http://hadm.sph.sc.edu/Courses/Econ/Classes/nhe00/

  2. U.S. National Health Expenditure from 1960 to 2006 2007 data: NHE: $ 2,241 billion GDP: $ 13,808 billion NHE % of GDP: 16.2

  3. Growth Rates of National Health Spending and Total Economy Spending

  4. Changes in Medical Care Prices and Changes in All Prices

  5. Who spent all the health care money?Who pays for all these services?

  6. Finer breakdown of who pays (i.e., the money flow) Payment financed by philanthropy, hospital fees, and gift shop and food sales Payment by private health insurance financed by premiums Uncompensated care: not included unless money is received through indigent care funds or extra charges on other payers.

  7. Amounts spent on each major category of health services and supplies

  8. Relative shares of the health services and supplies dollar

  9. Percentage of GDP contributed by personal spending of durable goods, non-durable goods and services Non-durables: food, clothing, gas, tobacco, Rx

  10. Breakdown of the services category

  11. U.S. Education Expenditures

  12. Growing Pressure on Government Spending Federal Outlays State General Fund Spending Total = $2.3 Trillion Total = $499 Billion SOURCE: CBO, Baseline Budget Outlook, January 2005; National Association of State Budget Officers, 2003 State Expenditure Report, 2004.

  13. Lecture 2: The Health of the U.S.

  14. Infant mortality rates, 2004

  15. Percentage of live births and infant deaths by weeks of gestation, 2005 Live births Infant deaths

  16. Low birth weight prevalence in other countries? • International comparisons of preterm births are even more problematic • differences in the completeness of registration of births • varying definitions of preterm births • inconsistent ascertainment of gestational age • high proportion of home births in these countries • difficulty of obtaining accurate information on menstrual dates • Canada: 6.2 (1981) 6.8 (1992) • Great Britain: 5.4 (1958) 5.1 (1970) • France: 6.8 (1976) 5.6 (1981) • Sweden: 5.5 (1973) 6.1 (1981) • The high rate of low birth weight births in developing countries is primarily due to intrauterine growth retardation, whereas preterm birth is a more important factor in developed countries.

  17. Non-medical causes: • motor vehicle traffic • firearms • poisoning • fall • suffocation • drowning

  18. Death Rates from Injuries, by Mechanism and Country [Average annual injury deaths per 100,000 population for time period indicated] Source: U.S. National Center for Health Statistics, Advance Data, No. 303, October 7, 1998.

  19. Age-Adjusted Death Rates* for the Five Leading Causes of Death --- United States, 2001--2006 * Per 100,000 standard population

  20. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1998, 2007 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1998 1990 2007 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  21. Lecture 2: Who consumes this care?

  22. How are US health care expenses distributed? Half of the population spends little or nothing on health care, while 5 percent of the population spends almost half of the total amount (2002). * The 22% and 49% (2002 figures) are down from 28% and 56% in 1996.

  23. Medicaid Enrollees and Expendituresby Enrollment Group, 2003 Elderly 9% Elderly 26% Disabled 16% Adults 27% Disabled 43% Children 48% Adults 12% Children 19% Total = 52.4 million Total = $252 billion Note: Total expenditures on benefits excludes DSH payments. SOURCE: KCMU estimates based on CBO and OMB data, 2004.

  24. Medicaid Payments Per Enrolleeby Acute and Long-Term Care, 2003 $12,800 $12,300 Long-Term Care Acute Care $1,900 $1,700 SOURCE: KCMU estimates based on CBO and Urban Institute data, 2004.

  25. How could we measure the health of our medical care system? • sustained good health • continued productivity • restored function after illness • avoided costs, rather than initial costs • waiting times • satisfaction with care

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