17% of the GDP

The health spendings projection article in Health Affairs contains this one historic note:

In 2009 the health share of gross domestic product (GDP) is expected to have increased 1.1 percentage points to 17.3 percent–the largest single-year increase since 1960.

A Los Angeles Times story gets to the heart of the matter:

“There is growing concern that as much as a third of the medical care delivered in this country does not help patients.

“Are we getting value for the dollar? That is the question,” said Len Nichols, health policy director at the centrist New America Foundation. “If you believe that so much medical care is unnecessary, as I do, then it is criminal that we are spending so much.”

Yet there is gridlock on federal health care reform legislation. Indeed, for all the rhetoric and fear-mongering about “government taking over health care,” the latest data shows we’re already there.


The Wall Street Journal reports and provides this graphic:

“For the first time, government programs next year will account for more than half of all U.S. health-care spending, federal actuaries predict, as the weak economy sends more people into Medicaid and slows growth of private insurance.”

One of the reasons we review news stories about “new stuff” in health care is that we believe news stories may drive up undue demand for unproven, perhaps unsafe, and costly new technologies without giving a balanced picture of the tradeoffs between harms and benefits, without evaluating the quality of evidence behind the new ideas, without looking at conflicts of interest in those promoting the new ideas, etc.

At last check, 70% of the nearly 1,000 stories we’ve reviewed fail to adequately discuss costs, or quantify harms or benefits. A kid-in-the-candy-store view of US health care.

We believe these are health care reform stories – even though they often aren’t presented that way. Just look at what we’ve written about just in the past week and you see the daily drumbeat of news stories and ads that fill our heads with visions of sugar plums in health care.

• CT and MRI scans

• Robotic surgery

• A weeklong network TV series taking you inside the O.R. for technological wonders

• Misleading drug ads

17.3% of the GDP and rising.

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February 4, 2010 at 1:47 pm

In many cases I am aware of, robots for surgery were used as a marketing device — patients would say, “do you have the robot?” In once case I know, the doc would bring in the patient, wheel in the robot, put the patient out, and then do the surgery by hand. Afterwords, the doc would tell the patient, “It turned out that your bone geometry was not correct for the robot to operate” or some such BS. This was in Europe and I don’t know the billing practices there, but the doc may have receive extra reimbursement for bringing the robot into the OR.


February 4, 2010 at 3:35 pm

Unfortunatly we have discovered the way for us to get to a single payer plan for all Americans. We will just let the demographics of aging and poverty eventually convert nearly everyone to either Medicare or Medicaid. If you toss in all the people working for federal, state, and local goverment, which essentially get their insurance from public funds, this percentage is likely higher. Eventually it will only be the Wall Street bankers that will be buying insurance privately.