Health Reform WK-EDGE Health care spending up, and number of insured, as data reveals trends
Wednesday, August 5, 2020

Health care spending up, and number of insured, as data reveals trends

By Cathleen Calhoun, J.D.

Will the COVID-19 pandemic set back the gains in health care?

In the U.S., health care spending, quality of care, access, affordability, and overall health and wellbeing trends have shown gains or losses in recent years. According to a Kaiser Family Foundation (KFF) brief, certain trends have the strong potential to decline due to the COVID-19 pandemic.

In its brief, KFF used data on more than 50 indicators across four domains: (1) health spending; (2) quality of care; (3) access and affordability; and (4) health and wellbeing. KFF broke down the information into 10 trends based on data available through 2018 or earlier years, and then examined how those trends have changed, or may change, due to the COVID-19 pandemic:

  1. Life expectancy. Sadly, even though life expectancy rose over the past several decades in the U.S., life expectancy has declined slightly in recent years, driven by mortality rates for certain causes of death, including suicide and opioid overdoses. Countries comparable to the U.S. have an average life expectancy of 82.3 years, almost four years longer than the U.S. life expectancy of 78.6 years, and the difference is growing. Since the COVID-19 pandemic is still on-going, data stemming from the pandemic is not yet available.
  2. Disease burden. Disease burden dropped 12 percent between 1990 and 2017, with sharp improvements for circulatory diseases. But, again, in the past few years the disease burden rate has worsened in the U.S., due to substance use disorders and a rise in injuries, while continuing to improve in similar countries. Also, although data is not yet available, the U.S. has high rates of disease burden attributable to some of the health conditions that put people at high risk of serious illness from COVID-19, including cardiovascular diseases, chronic respiratory diseases, and diabetes.
  3. Deaths prevented through healthcare. The U.S. has made gains in reducing the deaths amenable to healthcare. However, the U.S. has not improved as much as similar countries and ranks lowest on the Healthcare Quality and Access (HAQ) Index.
  4. Potential preventable hospital conditions. The U.S. rate of potentially preventable hospital admissions has decreased 32 percent from 2000 to 2015. However, potentially preventable hospital admission rates are higher in the U.S. compared to other countries for several diseases, including for congestive heart failure (88 percent higher), asthma (8 percent higher), and diabetes (53 percent higher). For hypertension, the U.S. admission rates are 12 percent lower than comparable country averages.
  5. Hospital-acquired conditions. From 2014 to 2017, hospital acquired conditions such as surgical infections and medication errors decreased 13 percent. It is unclear how the COVID-19 pandemic will impact this rate.
  6. Health insurance coverage. The uninsured rate among the nonelderly dropped from 18 percent in 2010 to 11 percent in 2018 due to the Affordable Care Act (ACA) (P.L. 111-148). The rate of coverage may decline, however, due to people losing jobs, and also health insurance, during in the COVID-19 pandemic. And, even though the U.S. has about 90 percent of the population covered with health insurance, the U.S. rate of coverage is lowest among comparable countries.
  7. Problems paying medical bills. The problem with paying medical bills has declined. The number of people reporting difficulty paying medical bills dropped by more than a quarter from 2011 to 2018. However, the pandemic could worsen the ability to pay.
  8. Delaying or forgoing care due to costs. Fewer patients, 4 percent, reported delaying care from 2009 to 2017. From 2017 to 2018, however, there was a slight increase. COVID-19 may create fewer delays for COVID-19 care, while delaying some care in other areas.
  9. Health spending per person. Health spending per person has increased over the past several decades. For the last decade, per capita spending in the U.S. has grown at an average rate of 3.6% per year, similar to the rate in comparable countries.
  10. Health spending growing faster than economy. Overall, health spending has grown faster than the economy. In the U.S., health consumption expenditures were 17.7 percent of the gross domestic product (GDP) in 2018. That percentage is much greater than comparable countries, where health spending averages 10.4 percent of GDP.

KFF noted that its dashboard of data is a starting point for exploring trends, and added, "it is important to keep in mind that not all indicators will change at the same pace, particularly with so many unknowns surrounding the current pandemic and economic crisis."

Companies: Kaiser Family Foundation

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