New Reports Reflect Conflicting Nature of the Cost of Health care

The news coming out of newly released CMS data showing that health care spending as a percentage of the economy fell in 2012 is encouraging for those working to revamp how health care is provided and paid for.

CMS actuaries calculated that the share of the economy devoted to health care fell to 17.2 percent from 17.3 percent as spending grew 3.7 percent and the GDP grew by 4.6 percent. As noted in a blog at Health Affairs, which published the CMS numbers, that rate of annual growth is close to the growth rates seen each year beginning in 2009. That four-year growth rate is the slowest in the 53-year history of the National Health Expenditure Accounts, according to the blog.

There of course is discourse about whether it’s the slowed economy or the ACA and other reform efforts that are behind the health care spending growth slowdown. I suggest we drop that argument to stay focused on implementing the ACA and other health reforms. Chances are that both health care reform and the weakish economy are contributing heavily if not equally to the relatively limited growth in health care spending.

Besides, there are patients and families struggling to pay for their health care that presumably may benefit from the slowdown in spending.

Even the insured can struggle with medical costs. A separate report from the Kaiser Family Foundation offers examples of how medical debt can become a major problem for patients.

The authors of the report, called "Medical Debt Among People With Health Insurance," studied the circumstances of 23 people struggling to pay their medical bills, and used the examination to draw some conclusions.

Cost-sharing in the form of deductibles and co-payments unsurprisingly is cited as a primary cause of difficult-to-manage medical debt by the authors. That problem is exacerbated by care that is unexpectedly provided by an out-of-network provider.

Among the other findings is that an illness often triggers income loss and further aggravates financial problems and that the mere fact of being sick may make it physically difficult to track medical expenses.

The authors note that provisions of the ACA will solve just some of the problems related to medical debt among the insured, providing another reason for health care reform to continue.