The future of health care in the United States Expenses:

The future of health care in the United States Expenses: - budgets and the private sector

The future of health care expenditures in the United States: budgets and the private sector

June 19, 2014 Emily Newhook

the current decline in the growth of health care spending has led many analysts to wonder if it is a trend that will persist or temporary change linked to the recession. During "The future of US health spending" conference, the Engelberg Center for reforming health care in Brookings hosted a panel discussion entitled "The importance of the growth of health spending to budgets and the private sector, "which featured a variety of health policy experts and economists. Here's a look panelists and key information they shared on trends in health care spending and its impact on different sectors of society.

The panel

William Gale is a major economic man and Arjay and Frances Miller Chair in federal economic policy in the economic studies program at Brookings. He is also co-director of the Urban-Brookings Tax Policy Center and director of the Retirement Security Project. His work focuses on taxation and tax policy, pensions and savings behavior.

Douglas Holtz-Eakin is an economist and current president of the American Action Forum. He has held many important political posts, including director of the Office of Congressional Budget 03-05, as well as positions in several think tanks based in Washington.

Donald Boyd is senior fellow at the Rockefeller Institute of Government with health expertise and policies of tax states. He is also the former director of the State Finance Research Group and Local Government Institute. He is the author of numerous reports on the tax climate in all 50 states.

Raymond Scheppach is a professor of the practice of public policy at the University of Virginia Frank Batten School of Leadership and Public Policy. He served as executive director of the National Association of Governors 1983-2011 and specializes in the role of states in shaping public policy and implementation.

Paul Ginsburg is Norman Topping Chair in Medicine and Public Policy and professor of the practice of politics and health management at the Sol Price School of the University of California South of public policy. He researches and consultations on the financing and delivery of health care, especially the evolution of health care markets. He was named one of the "100 Most Influential People in Health Care" eight times by Modern Healthcare.

Amanda Kowalski is an assistant professor of economics at Yale University and faculty researcher at the National Bureau of Economic Research. It is a health economist whose research focuses on the application of econometric techniques to inform current debates on health policy. His work has been published in journals peer reviewed and presented in the popular press.

Alice Rivlin , the president Leonard D. Schaeffer in health policy studies, director of the Engelberg Center for Reform and senior fellow healthcare in the economic studies program Brookings, moderated the panel. As an expert on fiscal and monetary policy, Rivlin was founding director of the Congressional Budget Office and recently served on the Commission of indebtedness President.

Key Insights

The panel covered the importance of growth in health spending from three points of view :. the federal budget, state and local governments and the private sector

federal budget

• watching the health care spending growth in the future, even in a "best scenario "without excessive cost growth, the federal debt further increases to 112 percent of GDP - 40 percentage points higher than the current debt. To maintain the current federal debt to GDP ratio, the additional necessary fiscal adjustments (ie spending cuts, tax increases) would total nearly $ 400 billion / year.
• Holtz-Eakin expressed deep concern regarding the trajectories of current spending, declaring: "This is a fiscal recipe for disaster because we let the legacy programs overwrite where the government federal really invests in the future and protects us and makes us stronger. "
• Some analysts believe that the adjustments should be avoided spending now because there is a degree of uncertainty in many forecasts . growth in health spending However, Gale said the spending adjustments are vital to the future health of the economy he suggested that adjustments are similar to the purchase of health insurance;. even if a person does not known if or when they get sick, they always buy the insurance to offset the risk of a financially burdensome illness in the future

@ JustRivlin: .. Why # healthspending question? If you spend on health care, you do not spend on something else

-. MHA @ GW (@GWonlineMHA) April 11, 2014

Local Government

• state and local health care spending nearly doubled as a percent of GDP over the past 25 years. Much of this growth can be attributed to increased Medicaid enrollment by the aging population and the cost of retiree health insurance.
• Given the increased spending and the trend of five years of almost no growth in state revenue, Scheppach asked, "What is that states and governors do? " Scheppach provides moderate tax increases, but expressed more concern regarding the cuts to "higher education ... because [state and local governments] look for places where they can transfer the cost."

private sector

• involvement of health spending in the private sector is the striking change of employer insurance premium increases on staff salaries; recent estimates suggest a premium increase of 10 percent reduced wages by 2.3 percent.
• Ginsburg noted, "the household sector will be affected by trends in Medicare and Medicaid spending and the tax expenditure for employer-sponsored insurance in the way they pay higher taxes or have to make due with less spending on other public priorities. "

Rivlin summarized the concerns that run through each statement, saying: "Yes [health care spending growth] really matters and if health spending goes back to what used to be the rate historical, we are all in trouble. "All panelists agreed that spending and budget control will be needed at all levels in the future. As health spending is evolving, it is essential that professionals in public health, including MHA @ GW graduates , emphasize the importance of public health programs, particularly in terms of reducing long-term costs associated with preventative care.