National health expenditures, 1997.

In 1997 health spending in the United States increased just 4.8 percent to $1.1 trillion. As a share of gross domestic product (GDP), national health expenditures (NHE) absorbed 13.5 percent of the country's output in 1997--a share that has remained relatively constant for 5 years. Despite the relative stability in recent years, signs of changing trends are emerging.

Introduction

Since 1964 the U.S. Department of Health and Human Services has published statistics presenting total health spending during each year. The basic aim of these statistics, termed NHE, is to “identify all goods and services that can be characterized as relating to health care in the nation, and determine the amount of money used for the purchase of these goods and services…” (Rice, Cooper, and Gibson, 1982).

In this article, we present NHE through an accounting structure to describe historical trends in the size, growth, and distribution of health care by type of service, such as hospital care and physician services, matched against the sources that pay the health care bill, such as private health insurance (PHI) and government programs like Medicare and Medicaid. This matrix provides policymakers, researchers, and the public with a system for understanding movement of the aggregate health economy and can serve as a data base from which hypotheses about the causal factors at work can be generated.

In the charts that follow, we present detailed information on our Nation's health spending, focusing on calendar year (CY) 1997. The charts are organized into three primary areas: an aggregate overview, the major sources of private and public funding, and the key service areas where our Nation's health dollars were spent. Included in the overview are estimates of total aggregate health spending, health expenditures as a share of GDP, the distribution of health spending by primary funding sources and services, and the basic economic factors accounting for the growth in health spending. The overview is followed by more detailed statistics on each of the primary funding sources including PHI, Medicare, Medicaid, and individual consumer health spending, as well as each of the primary service areas, including hospitals, physicians, prescription drugs, nursing homes, and home health services.

Tables 4-13 following the charts provide detailed NHE information for selected CYs by type of service and funding source. More complete time series estimates can be found online at http://www.hcfa.gov.

Table 4

National Health Expenditures Aggregate and per Capita Amounts, Percent Distribution, and Average Annual Percent Growth, by Source of Funds: Selected Calendar Years 1980-97

Item	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997
	Amount in Billions
National Health Expenditures	$247.3	$428.7	$699.4	$766.8	$836.5	$898.5	$947.7	$993.7	$1,042.5	$1,092.4
Private	142.5	254.5	416.2	448.9	483.6	513.2	524.9	538.5	561.1	585.3
Public	104.8	174.2	283.2	317.9	353.0	385.3	422.8	455.2	481.4	507.1
Federal	72.0	123.2	195.2	222.5	251.8	275.4	301.2	326.0	348.0	367.0
State and Local	32.8	51.0	88.0	95.4	101.2	110.0	121.6	129.2	133.4	140.0
	Number in Millions
U.S. Population1	235	247	260	263	265	268	271	273	276	278
	Amount in Billions
Gross Domestic Product	$2,784	$4,181	$5,744	$5,917	$6,244	$6,558	$6,947	$7,270	$7,662	$8,111
	Per Capita Amount
National Health Expenditures	$1,052	$1,735	$2,690	$2,918	$3,151	$3,350	$3,500	$3,637	$3,781	$3,925
Private	606	1,030	1,601	1,708	1,821	1,913	1,938	19,701	2,035	2,103
Public	446	705	1,089	1,210	1,330	1,437	1,561	1,666	1,746	1,822
Federal	306	498	751	847	948	1,027	1,112	1,193	1,262	1,319
State and Local	140	206	338	363	381	410	449	473	484	503
	Percent Distribution
National Health Expenditures	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Private	57.6	59.4	59.5	58.5	57.8	57.1	55.4	54.2	53.8	53.6
Public	42.4	40.6	40.5	41.5	42.2	42.9	44.6	45.8	46.2	46.4
Federal	29.1	28.7	27.9	29.0	30.1	30.6	31.8	32.8	33.4	33.6
State and Local	13.3	11.9	12.6	12.4	12.1	12.2	12.8	13.0	12.8	12.8
	Percent of Gross Domestic Product
National Health Expenditures	8.9	10.3	12.2	13.0	13.4	13.7	13.6	13.7	13.6	13.5
	Average Annual Percent Growth from Previous Year Shown
National Health Expenditures	211.7	11.6	10.3	9.6	9.1	7.4	5.5	4.9	4.9	4.8
Private	210.3	12.3	10.3	7.9	7.7	6.1	2.3	2.6	4.2	4.3
Public	214.8	10.7	10.2	12.3	11.0	9.2	9.7	7.7	5.7	5.3
Federal	217.4	11.3	9.6	14.0	13.1	9.4	9.4	8.2	6.8	5.5
State and Local	211.5	9.2	11.5	8.4	6.1	8.6	10.6	6.2	3.2	5.0
U.S. Population	21.1	1.0	1.0	1.0	1.0	1.0	1.0	0.9	0.9	0.9
Gross Domestic Product	28.7	8.5	6.6	3.0	5.5	5.0	5.9	4.6	5.4	5.9

July 1 Social Security area population estimates for each year, 1980-97.

Average annual growth between 1960 and 1980.

NOTE: Numbers and percents may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 13

Expenditures for Health Services and Supplies Under Public Programs, by Type of Expenditure and Program: Calendar Year 1997

Program Area	All Expenditures	Personal Health Care										Administration	Public Health Activities
		Total	Hospital Care	Physician Services	Dental Services	Other Professional Services	Home Health Care	Drugs and Other Medical Non-Durables	Vision Products and Other Medical Durables	Nursing Home Care	Other
	Amount in Billions
Public and Private Spending	$1,057.5	$969.0	$371.1	$217.6	$50.6	$61.9	$32.3	$108.9	$13.9	$82.8	$29.9	$50.0	$38.5
All Public Programs	485.5	432.4	228.4	70.1	2.3	13.6	17.7	16.0	6.6	51.4	26.3	14.7	38.5
Federal Funds	351.8	337.3	185.6	58.4	1.3	10.8	15.4	9.2	6.4	34.5	15.6	10.4	4.1
State and Local Funds	133.8	95.1	42.8	11.7	1.0	2.8	2.3	6.8	0.1	16.9	10.7	4.3	34.4
Medicare	214.6	208.9	123.7	46.4	0.1	8.8	12.8	1.0	6.0	10.1	—	5.7	—
Medicaid1	159.9	152.3	57.6	15.7	2.0	1.7	4.8	13.2	—	39.4	17.9	7.6	—
Federal	95.4	91.1	36.2	9.3	1.1	1.0	2.6	7.8	—	22.6	10.4	4.3	—
State and Local	64.5	61.2	21.4	6.4	0.9	0.7	2.1	5.5	—	16.8	7.5	3.3	—
Other State and Local Public Assistance Programs	5.4	5.4	2.9	0.3	0.1	0.4	0.1	1.1	0.0	0.1	0.3	—	—
Department of Veterans Affairs	16.6	16.6	13.6	0.2	0.0	—	—	0.0	0.3	1.7	0.7	0.1	—
Department of Defense2	13.4	13.3	10.0	1.7	0.0	—	—	0.4	—	—	1.2	0.2	—
Workers' Compensation	14.1	13.2	6.4	4.9	—	1.6	—	0.3	0.1	—	—	0.9	—
Federal	0.5	0.5	0.3	0.1	—	0.1	—	0.0	0.0	—	—	0.0	—
State and Local	13.6	12.7	6.1	4.8	—	1.5	—	0.3	0.1	—	—	0.9	—
State and Local Hospitals3	12.0	12.0	12.0	—	—	—	—	—	—	—	—	—	—
Other Public Programs for Personal Health Care4	11.1	10.8	2.2	0.9	0.1	1.2	—	0.0	0.1	—	6.2	0.3	—
Federal	7.0	6.9	1.8	0.7	0.1	1.0	—	0.0	0.1	—	3.2	0.1	—
State and Local	4.0	3.8	0.4	0.2	0.0	0.2	—	0.0	0.1	—	3.0	0.2	—
Government Public Health Activities	38.5	—	—	—	—	—	—	—	—	—	—	—	38.5
Federal	4.1	—	—	—	—	—	—	—	—	—	—	—	4.1
State and Local	34.4	—	—	—	—	—	—	—	—	—	—	—	34.4
Medicare and Medicaid	374.5	361.2	181.3	62.1	2.1	10.4	17.5	14.2	6.0	49.6	17.9	13.3	—

Excludes funds paid into the Medicare trust funds by States under buy-in agreements to cover premiums for Medicaid recipients.

Includes care for retirees and military dependents.

Expenditures not offset by revenues.

Includes program spending for maternal and child health; vocational rehabilitation medical payments; temporary disability insurance medical payments; Public Health Service and other Federal hospitals; Indian health services; alcoholism, drug abuse, and mental health; and school health.

NOTES: The figure 0.0 denotes amounts less than $50 million. Numbers may not add to total because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Conclusion

Over the past several years, health care expenditures have shown remarkable moderation in growth. Continued excess capacity in hospitals, efforts by employers to hold down cost increases, and the downward impact of BBA on Medicare costs over the next 5 years should moderate future health care expenditure growth.

However, beneath the recent calm waters are potential pressures for increased spending. Private insurers are seeing growth in benefit payments that exceed premiums earned and increasing demands by stockholders to improve eroding operating margins. Calls for increased quality and choice continue to be debated in State legislatures and in Congress, with the potential for accelerating the growth in benefit costs if enacted. At the same time, consolidation in the insurer and provider marketplaces could dampen the intense competitive pressures that have helped to keep the lid on premium price increases in recent years.

Additional pressures will likely come in the form of increased consumer demand (Smith et al., 1998). Recent strong economic growth has boosted employment and wages while prompting employers to offer health insurance to attract a qualified workforce. With rising incomes, the demand for new technologies and treatments will likely increase, including a continued upward trend in the fastest growing NHE category, prescription drugs. Although few expect a return to the double-digit growth of the past, significant forces for accelerated growth in future aggregate health spending are emerging.

Table 1

Distribution of Total Medicaid Payments, by Service: Selected Calendar Years 1967-97

Home and community-based waivers have had an impact on the distribution of Medicaid payments.

The use of home and community-based waivers by States has been growing. For Medicaid recipients at risk of needing long-term institutional care, States use these waivers in an attempt to treat this group in less expensive community-based settings. Medicaid spending under home and community-based waivers is included with other personal health care (OPHC) in the NHE. The growth in waivers may explain some of the shift in the distribution of Medicaid program payments from the nursing home category in the NHE to OPHC. OPHC increased from 3.5 percent of Medicaid payments for personal health care in 1987 to 11.8 percent in 1997, offsetting much of the decline in the nursing home share.

Service Category	1967	1977	1987	1997
	Percent
Personal Health Care	100.0	100.0	100.0	100.0
Hospital Care	54.0	43.3	39.5	37.8
Physician Services	11.5	11.4	9.4	10.3
Dental Services	4.5	2.6	1.2	1.3
Other Professional Services	0.9	1.0	0.7	1.1
Home Health Care	0.1	1.0	2.5	3.1
Non-Durables	6.7	6.2	7.1	8.7
Nursing Home Care	20.7	32.6	36.1	25.9
Other Personal Health Care	1.4	2.0	3.5	11.8

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 2

Medicare Population, Expenditures by Type of Coverage, and Service Distribution and Growth of Total Expenditures: Calendar Years 1990-97

1997 growth in Medicare spending was the slowest in a decade.

In 1997 Medicare spent $214.6 billion for health care, accounting for 19.6 percent of NHE. Annual growth in aggregate Medicare spending slowed from 12.2 percent in 1994 to 7.2 percent in 1997. This recent deceleration reflects, in part, slowing medical price increases, legislated limits that restrain growth in Medicare payments to providers, penalties in 1996 and 1997 in the form of stricter limits on the growth in physician fees imposed on physicians for exceeding the Medicare volume performance standards in 1994 and 1995, provider reaction to fraud and abuse activities, and decelerating growth in the Medicare population.

Growth in Medicare spending decelerated in 1997 for most types of benefits. The most notable exception is spending for physician services, which accelerated from 7.3 percent in 1996 to 8.5 percent in 1997. This acceleration is primarily attributable to the growth in enrollment in Medicare managed care plans. Medicare managed care plans tend to spend a larger percent of capitated payments on physician services than are purchased under Medicare fee-for-service (FFS)arrangements.

Type of Expenditure	1990	1991	1992	1993	1994	1995	1996	1997
	Number in Millions
Enrollees1	34.2	34.9	35.6	36.3	36.9	37.5	38.1	38.4
	Percent
Annual Percent Growth	1.9	1.9	2.0	2.0	1.7	1.6	1.4	1.0
	Amount in Billions
Health Services and Supplies	$111.5	$121.1	$136.2	$148.7	$166.9	$185.2	$200.1	$214.6
Fee-for-Service	106.1	114.9	128.8	139.6	155.4	170.2	179.5	186.8
Capitated Payments	5.3	6.2	7.4	9.1	11.5	15.0	20.5	27.8
	Percent Distribution of Total
Health Services and Supplies	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Personal Health Care	97.4	97.3	97.4	97.3	97.4	97.6	97.4	97.3
Hospital Care	61.6	61.0	61.7	60.6	59.8	58.8	58.1	57.7
Physician Services	26.2	25.1	23.0	22.3	21.7	21.5	21.4	21.6
Dental Services	(2)	(2)	(2)	(2)	(2)	(2)	(2)	(2)
Other Professional Services	2.9	3.4	3.7	3.8	4.0	4.2	4.2	4.1
Home Health Care	2.7	3.5	4.3	5.2	6.0	6.4	6.6	5.9
Drugs and Other Medical Non-Durables	0.1	0.1	0.1	0.1	0.2	0.2	0.4	0.4
Vision Products and Other Medical Durables	2.3	2.6	2.6	2.6	2.5	2.7	2.7	2.8
Nursing Home Care	1.6	1.6	2.1	2.7	3.3	3.6	4.0	4.7
Program Administration and Net Cost of Insurance3	2.6	2.7	2.6	2.7	2.6	2.4	2.6	2.7
	Annual Percent Change
Health Services and Supplies	8.9	8.6	12.4	9.2	12.2	11.0	8.0	7.2
Personal Health Care	9.1	8.5	12.6	9.1	12.4	11.1	7.8	7.2
Hospital Care	8.2	7.5	13.7	7.2	10.7	9.3	6.7	6.4
Physician Services	9.2	4.2	2.7	6.2	9.0	10.2	7.3	8.5
Dental Services	—	—	—	—	—	—	—	—
Other Professional Services	28.0	26.3	21.5	12.9	18.6	15.7	8.0	4.2
Home Health Care	50.1	39.9	39.0	31.8	28.9	19.5	10.3	-3.0
Drugs and Other Medical Non-Durables	18.1	16.6	18.9	38.8	69.3	76.4	60.4	33.2
Vision Products and Other Medical Durables	17.5	22.3	13.0	10.8	7.2	18.7	9.4	11.4
Nursing Home Care	-30.5	11.7	48.5	37.4	39.7	22.2	19.3	26.3
Program Administration and Net Cost of Insurance3	1.7	13.6	5.6	15.0	7.4	5.0	16.0	9.4

Hospital Insurance and/or Supplementary Medical Insurance enrollees as of July 1.

Less than 0.05 percent.

Includes administrative costs for the fee-for-service programs and administrative and net cost of insurance for Medicare managed care plans.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 3

Hospital Revenues, Percent Distribution, and Annual Percent Growth: Calendar Years 1991-97

Hospital revenue growth was focused on outpatient services.

One area of robust growth was outpatient revenues, which grew 10.3 percent in 1997, compared with a decline of 0.3 percent for inpatient revenues.

Type of Hospital	1991	1992	1993	1994	1995	1996	1997
	Revenues in Millions
Total	$282,272	$305,313	$322,995	$335,717	$347,227	$360,777	$371,061
Non-Federal	262,532	284,619	300,979	313,039	323,973	336,912	347,404
Community	245,463	267,841	284,702	297,247	308,490	321,242	331,251
Inpatient	183,506	196,422	206,273	211,075	214,649	218,321	217,736
Outpatient	61,957	71,419	78,429	86,172	93,841	102,921	113,515
Non-Community	17,069	16,778	16,277	15,792	15,483	15,670	16,153
Federal	19,740	20,694	22,016	22,678	23,254	23,865	23,658
	Percent Distribution
Total	100	100	100	100	100	100	100
Non-Federal	93	93	93	93	93	93	94
Community	87	88	88	89	89	89	89
Inpatient	65	64	64	63	62	61	59
Outpatient	22	23	24	26	27	29	31
Non-Community	6	5	5	5	4	4	4
Federal	7	7	7	7	7	7	6
	Annual Percent Growth
Total	10.1	8.2	5.8	3.9	3.4	3.9	2.9
Non-Federal	10.0	8.4	5.7	4.0	3.5	4.0	3.1
Community	10.8	9.1	6.3	4.4	3.8	4.1	3.1
Inpatient	8.4	7.0	5.0	2.3	1.7	1.7	-0.3
Outpatient	18.3	15.3	9.8	9.9	8.9	9.7	10.3
Non-Community	0.6	-1.7	-3.0	-3.0	-2.0	1.2	3.1
Federal	10.4	4.8	6.4	3.0	2.5	2.6	-0.9

NOTE: Non-community non-Federal hospitals include long-term care hospitals (where the average length of stay is 30 days or longer), psychiatric hospitals, alcohol and chemical dependency hospitals, units of institutions such as prison hospitals or college infirmaries, chronic disease hospitals, and some institutions for the mentally retarded.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 5

National Health Expenditures Aggregate Amounts and Average Annual Percent Change, by Type of Expenditure: Selected Calendar Years 1980-97

Type of Expenditure	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997
	Amount in Billions
National Health Expenditures	$247.3	$428.7	$699.4	$766.8	$836.5	$898.5	$947.7	$993.7	$1,042.5	$1,092.4
Health Services and Supplies	235.6	412.3	674.8	741.9	809.0	869.5	917.2	963.1	1,010.6	1,057.5
Personal Health Care	217.0	376.4	614.7	679.6	740.7	790.5	834.0	879.3	924.0	969.0
Hospital Care	102.7	168.3	256.4	282.3	305.3	323.0	335.7	347.2	360.8	371.1
Physician Services	45.2	83.6	146.3	162.2	175.9	185.9	193.0	201.9	208.5	217.6
Dental Services	13.3	21.7	31.6	33.3	37.0	39.5	42.4	45.0	47.5	50.6
Other Professional Services	6.4	16.6	34.7	38.3	42.1	46.1	49.6	53.6	57.5	61.9
Home Health Care	2.4	5.6	13.1	16.1	19.6	23.0	26.2	29.1	31.2	32.3
Drugs and Other Medical Non-Durables	21.6	37.1	59.9	65.6	71.2	76.2	81.6	88.9	98.3	108.9
Prescription Drugs	12.0	21.2	37.7	42.1	46.6	50.6	55.2	61.1	69.1	78.9
Vision Products and Other Medical Durables	3.8	6.7	10.5	11.2	11.9	12.3	12.5	13.1	13.4	13.9
Nursing Home Care	17.6	30.7	50.9	57.2	62.3	66.4	71.1	75.5	79.4	82.8
Other Personal Health Care	4.0	6.1	11.2	13.6	15.4	18.0	21.9	25.1	27.4	29.9
Program Administration and Net Cost of Private Health Insurance	11.9	24.3	40.5	40.9	44.9	53.7	55.1	53.3	52.5	50.0
Government Public Health Activities	6.7	11.6	19.6	21.4	23.4	25.3	28.2	30.4	34.0	38.5
Research and Construction	11.6	16.4	24.5	24.9	27.5	29.0	30.5	30.6	32.0	34.9
Research1	5.5	7.8	12.2	12.9	14.2	14.5	15.9	16.7	17.2	18.0
Construction	6.2	8.5	12.3	12.0	13.4	14.5	14.6	13.9	14.8	16.9
	Average Annual Percent Change from Previous Year Shown
National Health Expenditures	211.7	11.6	10.3	9.6	9.1	7.4	5.5	4.9	4.9	4.8
Health Services and Supplies	211.8	11.8	10.4	9.9	9.1	7.5	5.5	5.0	4.9	4.6
Personal Health Care	211.7	11.6	10.3	10.6	9.0	6.7	5.5	5.4	5.1	4.9
Hospital Care	212.8	10.4	8.8	10.1	8.2	5.8	3.9	3.4	3.9	2.9
Physician Services	211.3	13.1	11.8	10.8	8.5	5.7	3.8	4.6	3.3	4.4
Dental Services	210.0	10.2	7.8	5.6	11.0	6.8	7.3	6.1	5.6	6.5
Other Professional Services	212.5	21.2	15.8	10.4	10.0	9.6	7.5	8.1	7.2	7.7
Home Health Care	220.6	18.9	18.4	22.4	22.3	17.0	14.1	11.0	7.1	3.7
Drugs and Other Medical Non-Durables	28.5	11.4	10.1	9.4	8.6	7.1	7.0	9.0	10.6	10.7
Prescription Drugs	27.8	11.9	12.2	11.9	10.6	8.7	9.0	10.6	13.2	14.1
Vision Products and Other Medical Durables	29.2	12.4	9.2	7.0	6.3	3.4	1.5	4.9	2.3	3.6
Nursing Home Care	216.4	11.7	10.7	12.2	9.0	6.7	7.0	6.2	5.2	4.3
Other Personal Health Care	29.2	8.8	12.9	20.7	13.3	17.0	21.8	14.5	9.5	9.0
Program Administration and Net Cost of Private Health Insurance	212.3	15.4	10.8	0.8	9.9	19.5	2.7	-3.2	-1.5	-4.8
Government Public Health Activities	215.6	11.5	11.0	9.2	9.3	8.1	11.3	8.0	11.9	13.1
Research and Construction	210.1	7.1	8.4	1.7	10.5	5.3	5.1	0.5	4.3	9.2
Research1	210.9	7.5	9.3	5.8	9.8	2.2	9.6	5.2	2.6	4.7
Construction	29.5	6.7	7.6	-2.4	11.2	8.7	0.5	-4.6	6.3	14.3

Research and development expenditures of drug companies and other manufacturers and providers of medical equipment and supplies are excluded from research expenditures but are included in the expenditure class in which the product falls.

Average annual growth between 1960 and 1980.

NOTE: Numbers may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 6

National Health Expenditures, by Source of Funds and Type of Expenditure: Calendar Years 1992-97

Year and Type of Expenditure	Total	Private					Government
		All Private Funds	Consumer			Other
			Total	Out-of-Pocket Payments	Private Health Insurance		Total	Federal	State and Local
	Amount in Billions
1992
National Health Expenditures	$836.5	$483.6	$447.2	$161.8	$285.5	$36.3	$353.0	$251.8	$101.2
Health Services and Supplies	809.0	472.5	447.2	161.8	285.5	25.3	336.4	240.0	96.5
Personal Health Care	740.7	437.1	412.4	161.8	250.6	24.7	303.6	230.5	73.0
Hospital Care	305.3	132.5	120.9	13.7	107.2	11.6	172.8	138.7	34.1
Physician Services	175.9	123.6	120.5	33.7	86.8	3.2	52.3	40.4	11.8
Dental Services	37.0	35.6	35.5	17.8	17.7	0.1	1.4	0.8	0.6
Other Professional Services	42.1	33.1	30.1	15.2	14.8	3.0	9.0	6.3	2.7
Home Health Care	19.6	10.8	7.9	5.0	2.9	2.9	8.8	7.4	1.4
Drugs and Other Medical Non-Durables	71.2	62.9	62.9	45.0	17.9	—	8.3	4.2	4.1
Vision Products and Other Medical Durables	11.9	8.0	8.0	7.3	0.7	—	3.9	3.8	0.1
Nursing Home Care	62.3	27.9	26.7	24.1	2.6	1.2	34.4	21.2	13.2
Other Personal Health Care	15.4	2.6	—	—	—	2.6	12.7	7.8	5.0
Program Administration and Net Cost of Private Health Insurance	44.9	35.4	34.8	—	34.8	0.6	9.5	6.4	3.1
Government Public Health Activities	23.4	—	—	—	—	—	23.4	3.0	20.4
Research and Construction	27.5	11.0	—	—	—	11.0	16.5	11.8	4.7
Research	14.2	1.2	—	—	—	1.2	13.0	11.0	2.0
Construction	13.4	9.8	—	—	—	9.8	3.5	0.8	2.8
1993
National Health Expenditures	898.5	513.2	473.9	167.1	306.8	39.3	385.3	275.4	110.0
Health Services and Supplies	869.5	501.3	473.9	167.1	306.8	27.4	368.2	263.3	104.9
Personal Health Care	790.5	459.1	432.3	167.1	265.2	26.8	331.4	252.3	79.1
Hospital Care	323.0	136.7	124.0	14.1	109.9	12.7	186.3	148.8	37.5
Physician Services	185.9	130.4	127.1	33.0	94.1	3.3	55.5	43.4	12.1
Dental Services	39.5	37.6	37.5	18.8	18.7	0.2	1.9	1.1	0.8
Other Professional Services	46.1	36.2	32.8	17.0	15.8	3.4	9.9	7.1	2.8
Home Health Care	23.0	11.9	8.7	5.6	3.1	3.2	11.1	9.5	1.5
Drugs and Other Medical Non-Durables	76.2	66.9	66.9	46.8	20.1	—	9.3	4.9	4.4
Vision Products and Other Medical Durables	12.3	8.0	8.0	7.3	0.7	—	4.3	4.2	0.1
Nursing Home Care	66.4	28.6	27.3	24.5	2.8	1.2	37.9	24.0	13.9
Other Personal Health Care	18.0	2.8	—	—	—	2.8	15.1	9.2	5.9
Program Administration and Net Cost of Private Health Insurance	53.7	42.1	41.6	—	41.6	0.6	11.5	7.7	3.8
Government Public Health Activities	25.3	—	—	—	—	—	25.3	3.3	22.0
Research and Construction	29.0	11.9	—	—	—	11.9	17.1	12.1	5.0
Research	14.5	1.2	—	—	—	1.2	13.3	11.1	2.1
Construction	14.5	10.7	—	—	—	10.7	3.8	0.9	2.9
1994
National Health Expenditures	$947.7	$524.9	$483.6	$168.5	$315.1	$41.3	$422.8	$301.2	$121.6
Health Services and Supplies	917.2	513.1	483.6	168.5	315.1	29.5	404.1	288.0	116.1
Personal Health Care	834.0	472.0	443.0	168.5	274.5	28.9	362.0	275.7	86.3
Hospital Care	335.7	134.9	121.2	12.7	108.6	13.7	200.8	159.9	40.9
Physician Services	193.0	133.9	130.3	31.4	98.9	3.6	59.1	46.8	12.4
Dental Services	42.4	40.4	40.2	20.0	20.2	0.2	2.0	1.1	0.9
Other Professional Services	49.6	38.5	34.7	18.3	16.4	3.7	11.1	8.3	2.8
Home Health Care	26.2	12.5	9.2	5.9	3.3	3.4	13.7	11.9	1.8
Drugs and Other Medical Non-Durables	81.6	71.2	71.2	47.8	23.5	—	10.4	5.4	4.9
Vision Products and Other Medical Durables	12.5	7.8	7.8	7.2	0.6	—	4.6	4.5	0.1
Nursing Home Care	71.1	29.6	28.3	25.3	3.0	1.3	41.4	26.5	14.9
Other Personal Health Care	21.9	3.1	—	—	—	3.1	18.8	11.3	7.5
Program Administration and Net Cost of Private Health Insurance	55.1	41.2	40.6	—	40.6	0.6	13.9	8.5	5.5
Government Public Health Activities	28.2	—	—	—	—	—	28.2	3.8	24.4
Research and Construction	30.5	11.8	—	—	—	11.8	18.7	13.2	5.5
Research	15.9	1.3	—	—	—	1.3	14.6	12.3	2.3
Construction	14.6	10.5	—	—	—	10.5	4.1	0.9	3.2
1995
National Health Expenditures	993.7	538.5	495.3	171.0	324.3	43.2	455.2	326.0	129.2
Health Services and Supplies	963.1	527.6	495.3	171.0	324.3	32.3	435.5	312.0	123.5
Personal Health Care	879.3	489.2	457.6	171.0	286.6	31.6	390.1	299.0	91.2
Hospital Care	347.2	133.7	118.8	11.5	107.3	14.9	213.5	170.6	42.9
Physician Services	201.9	138.6	134.4	30.0	104.4	4.2	63.2	50.9	12.4
Dental Services	45.0	43.0	42.8	21.1	21.7	0.2	2.0	1.1	0.9
Other Professional Services	53.6	41.2	37.1	19.9	17.2	4.1	12.4	9.5	2.9
Home Health Care	29.1	13.1	9.6	6.2	3.4	3.5	16.0	14.0	1.9
Drugs and Other Medical Non-Durables	88.9	77.2	77.2	48.6	28.6	—	11.7	6.3	5.4
Vision Products and Other Medical Durables	13.1	7.7	7.7	7.1	0.6	—	5.4	5.3	0.1
Nursing Home Care	75.5	31.4	30.0	26.6	3.4	1.4	44.0	28.4	15.6
Other Personal Health Care	25.1	3.3	—	—	—	3.3	21.8	12.8	9.0
Program Administration and Net Cost of Private Health Insurance	53.3	38.4	37.7	—	37.7	0.7	15.0	9.2	5.7
Government Public Health Activities	30.4	—	—	—	—	—	30.4	3.8	26.6
Research and Construction	30.6	11.0	—	—	—	11.0	19.7	14.0	5.7
Research	16.7	1.3	—	—	—	1.3	15.4	12.9	2.5
Construction	13.9	9.6	—	—	—	9.6	4.3	1.1	3.2
1996
National Health Expenditures	$1,042.5	$561.1	$515.2	$178.1	$337.1	$45.9	$481.4	$348.0	$133.4
Health Services and Supplies	1,010.6	549.5	515.2	178.1	337.1	34.2	461.1	333.6	127.5
Personal Health Care	924.0	511.4	477.9	178.1	299.8	33.5	412.6	319.8	92.8
Hospital Care	360.8	138.0	121.9	11.8	110.0	16.1	222.8	179.6	43.2
Physician Services	208.5	142.3	138.0	31.1	106.9	4.3	66.2	54.4	11.8
Dental Services	47.5	45.4	45.2	22.1	23.2	0.2	2.1	1.2	0.9
Other Professional Services	57.5	44.3	40.0	21.9	18.0	4.3	13.2	10.4	2.8
Home Health Care	31.2	13.7	10.0	6.5	3.5	3.7	17.5	15.5	2.0
Drugs and Other Medical Non-Durables	98.3	84.9	84.9	51.0	33.9	—	13.4	7.5	5.9
Vision Products and Other Medical Durables	13.4	7.5	7.5	6.9	0.6	—	5.9	5.8	0.1
Nursing Home Care	79.4	31.9	30.4	26.7	3.7	1.5	47.4	31.3	16.2
Other Personal Health Care	27.4	3.4	—	—	—	3.4	24.0	14.1	9.9
Program Administration and Net Cost of Private Health Insurance	52.5	38.0	37.3	—	37.3	0.7	14.5	9.9	4.5
Government Public Health Activities	34.0	—	—	—	—	—	34.0	3.9	30.1
Research and Construction	32.0	11.7	—	—	—	11.7	20.3	14.4	5.9
Research	17.2	1.4	—	—	—	1.4	15.7	13.2	2.5
Construction	14.8	10.3	—	—	—	10.3	4.6	1.2	3.3
1997
National Health Expenditures	1,092.4	585.3	535.6	187.6	348.0	49.7	507.1	367.0	140.0
Health Services and Supplies	1,057.5	571.9	535.6	187.6	348.0	36.4	485.5	351.8	133.8
Personal Health Care	969.0	536.7	501.0	187.6	313.5	35.6	432.4	337.3	95.1
Hospital Care	371.1	142.6	125.4	12.4	113.0	17.2	228.4	185.6	42.8
Physician Services	217.6	147.5	143.2	34.1	109.1	4.3	70.1	58.4	11.7
Dental Services	50.6	48.4	48.1	23.9	24.3	0.2	2.3	1.3	1.0
Other Professional Services	61.9	48.3	43.5	24.6	18.9	4.8	13.6	10.8	2.8
Home Health Care	32.3	14.7	10.7	7.0	3.7	3.9	17.7	15.4	2.3
Drugs and Other Medical Non-Durables	108.9	92.9	92.9	53.0	39.9	—	16.0	9.2	6.8
Vision Products and Other Medical Durables	13.9	7.3	7.3	6.8	0.5	—	6.6	6.4	0.1
Nursing Home Care	82.8	31.3	29.8	25.7	4.0	1.6	51.4	34.5	16.9
Other Personal Health Care	29.9	3.6	—	—	—	3.6	26.3	15.6	10.7
Program Administration and Net Cost of Private Health Insurance	50.0	35.3	34.6	—	34.6	0.7	14.7	10.4	4.3
Government Public Health Activities	38.5	—	—	—	—	—	38.5	4.1	34.4
Research and Construction	34.9	13.4	—	—	—	13.4	21.5	15.3	6.3
Research	18.0	1.5	—	—	—	1.5	16.5	13.8	2.6
Construction	16.9	11.9	—	—	—	11.9	5.1	1.4	3.6

NOTES: Research and development expenditures of drug companies and other manufacturers and providers of medical equipment and supplies are excluded from research expenditures, but are included in the expenditure class in which the product falls. Numbers may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 7

Personal Health Care Expenditures Aggregate and Per Capita Amounts and Percent Distribution, by Source of Funds: Selected Calendar Years 1980-97

Year	Total	Out-of-Pocket Payments	Third-Party Payments						Medicare1	Medicaid2
			Total	Private Health Insurance	Other Private Funds	Government
						Total	Federal	State and Local
	Amount in Billions
1980	$217.0	$60.3	$156.8	$62.0	$7.8	$87.0	$63.4	$23.6	$36.4	$24.8
1985	376.4	100.7	275.8	114.1	14.0	147.7	111.1	36.6	70.0	39.1
1990	614.7	145.0	469.6	207.7	20.8	241.1	177.0	64.2	108.6	71.4
1991	679.6	153.3	526.2	229.8	23.1	273.4	203.2	70.2	117.8	89.6
1992	740.7	161.8	578.9	250.6	24.7	303.6	230.5	73.0	132.7	101.5
1993	790.5	167.1	623.5	265.2	26.8	331.4	252.3	79.1	144.7	115.8
1994	834.0	168.5	665.5	274.5	28.9	362.0	275.7	86.3	162.6	126.9
1995	879.3	171.0	708.3	286.6	31.6	390.1	299.0	91.2	180.7	137.2
1996	924.0	178.1	745.9	299.8	33.5	412.6	319.8	92.8	194.9	146.3
1997	969.0	187.6	781.5	313.5	35.6	432.4	337.3	95.1	208.9	152.3
	Per Capita Amount
1980	$923	$256	$667	$264	$33	$370	$270	$100	(3)	(3)
1985	1,523	407	1,116	462	57	598	449	148	(3)	(3)
1990	2,364	558	1,806	799	80	927	681	247	(3)	(3)
1991	2,586	584	2,003	875	88	1,040	773	267	(3)	(3)
1992	2,790	609	2,181	944	93	1,143	868	275	(3)	(3)
1993	2,947	623	2,325	989	100	1,236	941	295	(3)	(3)
1994	3,080	622	2,458	1,014	107	1,337	1,018	319	(3)	(3)
1995	3,218	626	2,592	1,049	116	1,428	1,094	334	(3)	(3)
1996	3,351	646	2,705	1,087	121	1,496	1,160	337	(3)	(3)
1997	3,482	674	2,808	1,126	128	1,554	1,212	342	(3)	(3)
	Percent Distribution
1980	100.0	27.8	72.2	28.6	3.6	40.1	29.2	10.9	16.8	11.4
1985	100.0	26.7	73.3	30.3	3.7	39.2	29.5	9.7	18.6	10.4
1990	100.0	23.6	76.4	33.8	3.4	39.2	28.8	10.4	17.7	11.6
1991	100.0	22.6	77.4	33.8	3.4	40.2	29.9	10.3	17.3	13.2
1992	100.0	21.8	78.2	33.8	3.3	41.0	31.1	9.9	17.9	13.7
1993	100.0	21.1	78.9	33.6	3.4	41.9	31.9	10.0	18.3	14.6
1994	100.0	20.2	79.8	32.9	3.5	43.4	33.1	10.3	19.5	15.2
1995	100.0	19.4	80.6	32.6	3.6	44.4	34.0	10.4	20.6	15.6
1996	100.0	19.3	80.7	32.4	3.6	44.7	34.6	10.0	21.1	15.8
1997	100.0	19.4	80.6	32.3	3.7	44.6	34.8	9.8	21.6	15.7

Subset of Federal funds.

Subset of Federal and State and local funds.

Calculation of per capita estimates is inappropriate.

NOTES: Per capita amounts based on July 1 Social Security area population estimates for each year, 1980-97. Numbers and percents may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 8

Hospital Care Expenditures Aggregate and Per Capita Amounts and Percent Distribution, by Source of Funds: Selected Calendar Years 1980-97

Year	Total	Out-of-Pocket Payments	Third-Party Payments						Medicare1	Medicaid2
			Total	Private Health Insurance	Other Private Funds	Government
						Total	Federal	State and Local
	Amount in Billions
1980	$102.7	$5.3	$97.4	$36.5	$5.0	$55.9	$42.1	$13.7	$26.4	$10.6
1985	168.3	8.8	159.5	59.0	8.3	92.3	72.3	19.9	49.0	15.7
1990	256.4	11.1	245.4	95.6	10.2	139.6	105.4	34.2	68.7	29.4
1991	282.3	13.0	269.3	101.9	11.3	156.1	121.4	34.7	73.9	37.8
1992	305.3	13.7	291.6	107.2	11.6	172.8	138.7	34.1	84.0	42.4
1993	323.0	14.1	308.9	109.9	12.7	186.3	148.8	37.5	90.1	48.4
1994	335.7	12.7	323.1	108.6	13.7	200.8	159.9	40.9	99.7	52.8
1995	347.2	11.5	335.7	107.3	14.9	213.5	170.6	42.9	108.9	56.7
1996	360.8	11.8	348.9	110.0	16.1	222.8	179.6	43.2	116.3	59.0
1997	371.1	12.4	358.6	113.0	17.2	228.4	185.6	42.8	123.7	57.6
	Per Capita Amount
1980	$437	$23	$414	$155	$21	$238	$179	$58	(3)	(3)
1985	681	36	645	239	33	373	293	81	(3)	(3)
1990	986	43	944	368	39	537	405	132	(3)	(3)
1991	1,074	49	1,025	388	43	594	462	132	(3)	(3)
1992	1,150	52	1,098	404	44	651	522	128	(3)	(3)
1993	1,204	52	1,152	410	47	695	554	140	(3)	(3)
1994	1,240	47	1,193	401	50	742	590	151	(3)	(3)
1995	1,271	43	1,229	393	54	781	624	157	(3)	(3)
1996	1,308	43	1,265	399	58	808	651	157	(3)	(3)
1997	1,333	45	1,289	406	61	821	667	154	(3)	(3)
	Percent Distribution
1980	100.0	5.2	94.8	35.5	4.9	54.4	41.0	13.4	25.7	10.3
1985	100.0	5.2	94.8	35.0	4.9	54.8	43.0	11.9	29.1	9.3
1990	100.0	4.3	95.7	37.3	4.0	54.5	41.1	13.3	26.8	11.5
1991	100.0	4.6	95.4	36.1	4.0	55.3	43.0	12.3	26.2	13.4
1992	100.0	4.5	95.5	35.1	3.8	56.6	45.4	11.2	27.5	13.9
1993	100.0	4.4	95.6	34.0	3.9	57.7	46.1	11.6	27.9	15.0
1994	100.0	3.8	96.2	32.3	4.1	59.8	47.6	12.2	29.7	15.7
1995	100.0	3.3	96.7	30.9	4.3	61.5	49.1	12.4	31.4	16.3
1996	100.0	3.3	96.7	30.5	4.5	61.8	49.8	12.0	32.2	16.4
1997	100.0	3.3	96.7	30.5	4.6	61.6	50.0	11.5	33.3	15.5

Subset of Federal funds.

Subset of Federal and State and local funds.

Calculation of per capita estimates is inappropriate.

NOTES: Per capita amounts based on July 1 Social Security area population estimates for each year, 1980-97. Numbers and percents may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 9

Physician Service Expenditures Aggregate and Per Capita Amounts and Percent Distribution, by Source of Funds: Selected Calendar Years 1980-97

Year	Total	Out-of-Pocket Payments	Third-Party Payments						Medicare1	Medicaid2
			Total	Private Health Insurance	Other Private Funds	Government
						Total	Federal	State and Local
	Amount in Billions
1980	$45.2	$14.7	$30.6	$17.1	$0.4	$13.1	$10.0	$3.1	$8.0	$2.5
1985	83.6	24.4	59.2	33.5	1.4	24.3	19.4	4.9	16.3	3.5
1990	146.3	32.2	114.2	66.8	2.7	44.7	35.6	9.1	29.2	7.0
1991	162.2	33.3	128.9	77.2	2.9	48.8	38.2	10.6	30.5	9.1
1992	175.9	33.7	142.2	86.8	3.2	52.3	40.4	11.8	31.3	11.1
1993	185.9	33.0	153.0	94.1	3.3	55.5	43.4	12.1	33.2	12.7
1994	193.0	31.4	161.6	98.9	3.6	59.1	46.8	12.4	36.2	13.6
1995	201.9	30.0	171.8	104.4	4.2	63.2	50.9	12.4	39.9	14.4
1996	208.5	31.1	177.4	106.9	4.3	66.2	54.4	11.8	42.8	15.2
1997	217.6	34.1	183.6	109.1	4.3	70.1	58.4	11.7	46.4	15.7
	Per Capita Amount
1980	$192	$62	$130	$73	$2	$56	$43	$13	(3)	(3)
1985	338	99	239	136	6	98	79	20	(3)	(3)
1990	563	124	439	257	10	172	137	35	(3)	(3)
1991	617	127	490	294	11	186	146	40	(3)	(3)
1992	663	127	536	327	12	197	152	45	(3)	(3)
1993	693	123	570	351	12	207	162	45	(3)	(3)
1994	713	116	597	365	13	218	173	46	(3)	(3)
1995	739	110	629	382	15	231	186	45	(3)	(3)
1996	756	113	643	388	15	240	197	43	(3)	(3)
1997	782	122	660	392	15	252	210	42	(3)	(3)
	Percent Distribution
1980	100.0	32.4	67.6	37.9	0.8	28.9	22.1	6.8	17.6	5.5
1985	100.0	29.2	70.8	40.1	1.6	29.1	23.2	5.9	19.5	4.2
1990	100.0	22.0	78.0	45.7	1.8	30.5	24.3	6.2	20.0	4.8
1991	100.0	20.5	79.5	47.6	1.8	30.1	23.6	6.5	18.8	5.6
1992	100.0	19.2	80.8	49.3	1.8	29.7	23.0	6.7	17.8	6.3
1993	100.0	17.7	82.3	50.6	1.8	29.9	23.4	6.5	17.9	6.8
1994	100.0	16.3	83.7	51.3	1.9	30.6	24.2	6.4	18.8	7.0
1995	100.0	14.9	85.1	51.7	2.1	31.3	25.2	6.1	19.8	7.2
1996	100.0	14.9	85.1	51.3	2.0	31.8	26.1	5.7	20.5	7.3
1997	100.0	15.7	84.3	50.2	2.0	32.2	26.8	5.4	21.3	7.2

Subset of Federal funds.

Subset of Federal and State and local funds.

Calculation of per capita estimates is inappropriate.

NOTES: Per capita amounts based on July 1 Social Security area population estimates for each year, 1980-97. Numbers and percents may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 10

Nursing Home Care Expenditures Aggregate and Per Capita Amounts and Percent Distribution, by Source of Funds: Selected Calendar Years 1980-97

Year	Total	Out-of-Pocket Payments	Third-Party Payments						Medicare1	Medicaid2
			Total	Private Health Insurance	Other Private Funds	Government
						Total	Federal	State and Local
	Amount in Billions
1980	$17.6	$7.4	$10.3	$0.2	$0.5	$9.5	$5.6	$3.9	$0.3	$8.8
1985	30.7	13.6	17.1	0.8	0.6	15.7	9.2	6.5	0.5	14.5
1990	50.9	21.9	29.0	2.1	0.9	25.9	15.8	10.2	1.7	23.1
1991	57.2	23.1	34.1	2.4	1.1	30.6	18.4	12.3	1.9	27.5
1992	62.3	24.1	38.2	2.6	1.2	34.4	21.2	13.2	2.9	30.2
1993	66.4	24.5	41.9	2.8	1.2	37.9	24.0	13.9	3.9	32.4
1994	71.1	25.3	45.8	3.0	1.3	41.4	26.5	14.9	5.5	34.3
1995	75.5	26.6	48.8	3.4	1.4	44.0	28.4	15.6	6.7	35.6
1996	79.4	26.7	52.7	3.7	1.5	47.4	31.3	16.2	8.0	37.6
1997	82.8	25.7	57.0	4.0	1.6	51.4	34.5	16.9	10.1	39.4
	Per Capita Amount
1980	$75	$31	$44	$1	$2	$41	$24	$17	(3)	(3)
1985	124	55	69	3	2	64	37	26	(3)	(3)
1990	196	84	111	8	4	100	61	39	(3)	(3)
1991	218	88	130	9	4	117	70	47	(3)	(3)
1992	235	91	144	10	4	130	80	50	(3)	(3)
1993	248	91	156	10	5	141	90	52	(3)	(3)
1994	263	93	169	11	5	153	98	55	(3)	(3)
1995	276	97	179	12	5	161	104	57	(3)	(3)
1996	288	97	191	14	5	172	113	59	(3)	(3)
1997	297	92	205	14	6	185	124	61	(3)	(3)
	Percent Distribution
1980	100.0	41.8	58.2	1.2	3.0	54.0	31.8	22.2	1.7	50.0
1985	100.0	44.3	55.7	2.7	1.8	51.2	29.9	21.2	1.5	47.2
1990	100.0	43.1	56.9	4.1	1.8	51.0	31.0	20.0	3.4	45.4
1991	100.0	40.4	59.6	4.2	1.8	53.6	32.1	21.5	3.4	48.1
1992	100.0	38.7	61.3	4.2	1.9	55.2	34.1	21.2	4.6	48.5
1993	100.0	36.9	63.1	4.2	1.8	57.0	36.2	20.9	5.9	48.8
1994	100.0	35.6	64.4	4.3	1.9	58.3	37.3	21.0	7.8	48.2
1995	100.0	35.3	64.7	4.5	1.9	58.3	37.6	20.7	8.9	47.1
1996	100.0	33.6	66.4	4.7	1.9	59.8	39.4	20.4	10.1	47.4
1997	100.0	31.1	68.9	4.9	1.9	62.2	41.7	20.4	12.3	47.6

Subset of Federal funds.

Subset of Federal and State and local funds.

Calculation of per capita estimates is inappropriate.

NOTES: Per capita amounts based on July 1 Social Security area population estimates for each year, 1980-97. Numbers and percents may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 11

Other Personal Health Care Expenditures Aggregate and Per Capita Amounts and Percent Distribution, by Source of Funds: Selected Calendar Years 1980-97

Year	Total	Out-of-Pocket Payments	Third-Party Payments						Medicare2	Medicaid3
			Total	Private Health Insurance	Other Private Funds	Government
						Total	Federal	State and Local
	Amount in Billions
1980	$51.5	$32.9	$18.6	$8.2	$1.9	$8.5	$5.6	$2.8	$1.7	$2.8
1985	93.9	53.8	40.0	20.8	3.8	15.4	10.2	5.3	4.3	5.3
1990	161.0	79.9	81.1	43.2	7.0	30.9	20.2	10.7	8.9	11.8
1991	178.0	84.0	94.0	48.4	7.8	37.8	25.2	12.6	11.6	15.2
1992	197.2	90.3	106.9	54.1	8.7	44.1	30.1	13.9	14.5	17.8
1993	215.1	95.5	119.7	58.4	9.6	51.7	36.0	15.7	17.5	22.2
1994	234.2	99.2	135.0	64.0	10.3	60.6	42.6	18.0	21.2	26.2
1995	254.8	102.8	152.0	71.5	11.1	69.3	49.1	20.2	25.2	30.5
1996	275.3	108.4	166.9	79.1	11.6	76.1	54.5	21.6	27.8	34.5
1997	297.5	115.3	182.2	87.3	12.6	82.4	58.7	23.7	28.6	39.6
	Per Capita Amount
1980	$219	$140	$79	$35	$8	$36	$24	$12	(4)	(4)
1985	380	218	162	84	15	62	41	21	(4)	(4)
1990	619	307	312	166	27	119	78	41	(4)	(4)
1991	677	320	358	184	30	144	96	48	(4)	(4)
1992	743	340	403	204	33	166	114	53	(4)	(4)
1993	802	356	446	218	36	193	134	58	(4)	(4)
1994	865	366	498	236	38	224	157	67	(4)	(4)
1995	932	376	556	262	41	254	180	74	(4)	(4)
1996	998	393	605	287	42	276	198	78	(4)	(4)
1997	1,069	414	655	314	45	296	211	85	(4)	(4)
	Percent Distribution
1980	100.0	63.9	36.1	15.9	3.6	16.5	11.0	5.5	3.2	5.5
1985	100.0	57.3	42.7	22.2	4.1	16.4	10.8	5.6	4.6	5.7
1990	100.0	49.6	50.4	26.9	4.3	19.2	12.5	6.6	5.5	7.3
1991	100.0	47.2	52.8	27.2	4.4	21.3	14.2	7.1	6.5	8.6
1992	100.0	45.8	54.2	27.4	4.4	22.4	15.3	7.1	7.4	9.0
1993	100.0	44.4	55.6	27.1	4.5	24.0	16.7	7.3	8.1	10.3
1994	100.0	42.4	57.6	27.3	4.4	25.9	18.2	7.7	9.0	11.2
1995	100.0	40.4	59.6	28.1	4.4	27.2	19.3	7.9	9.9	12.0
1996	100.0	39.4	60.6	28.7	4.2	27.6	19.8	7.9	10.1	12.5
1997	100.0	38.8	61.2	29.3	4.2	27.7	19.7	8.0	9.6	13.3

Personal health care expenditures other than those for hospital care, physician services, and nursing home care.

Subset of Federal funds.

Subset of Federal and State and local funds.

Calculation of per capita estimates is inappropriate.

NOTES: Per capita amounts based on July 1 Social Security area population estimates for each year, 1980-97. Numbers and percents may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.

Table 12

Personal Health Care Expenditures, by Type of Expenditure and Source of Funds: Calendar Years 1990-97

Source of Funds	Total	Hospital Care	Physician Services	Dental Services	Other Professional Services	Home Health Care	Drugs and Other Medical Non-Durables	Vision Products and Other Medical Durables	Nursing Home Care	Other Personal Health Care
	Amount in Billions
1990
Personal Health Care Expenditures	$614.7	$256.4	$146.3	$31.6	$34.7	$13.1	$59.9	$10.5	$50.9	$11.2
Out-of-Pocket Payments	145.0	11.1	32.2	15.4	13.7	3.6	40.4	6.7	21.9	—
Third-Party Payments	469.6	245.4	114.2	16.2	21.0	9.5	19.5	3.7	29.0	11.2
Private Health Insurance	207.7	95.6	66.8	15.1	12.0	2.2	13.0	0.8	2.1	—
Other Private	20.8	10.2	2.7	0.1	2.5	2.2	—	—	0.9	2.2
Government	241.1	139.6	44.7	0.9	6.5	5.1	6.5	2.9	25.9	9.0
Federal	177.0	105.4	35.6	0.5	4.3	4.1	3.1	2.7	15.8	5.4
Medicare	108.6	68.7	29.2	0.0	3.3	3.0	0.1	2.5	1.7	—
Medicaid	40.4	16.6	4.1	0.4	0.3	1.1	2.9	—	13.0	2.0
Other	28.0	20.1	2.2	0.1	0.7	—	0.1	0.2	1.0	3.5
State and Local	64.2	34.2	9.1	0.4	2.2	1.0	3.4	0.1	10.2	3.6
Medicaid	31.0	12.9	2.9	0.3	0.2	1.0	2.1	—	10.1	1.5
Other	33.1	21.4	6.2	0.1	2.0	0.0	1.2	0.1	0.1	2.1
1991
Personal Health Care Expenditures	679.6	282.3	162.2	33.3	38.3	16.1	65.6	11.2	57.2	13.6
Out-of-Pocket Payments	153.3	13.0	33.3	16.1	14.0	4.3	42.7	6.9	23.1	—
Third-Party Payments	526.2	269.3	128.9	17.2	24.3	11.7	22.9	4.3	34.1	13.6
Private Health Insurance	229.8	101.9	77.2	16.0	13.9	2.5	15.2	0.8	2.4	—
Other Private	23.1	11.3	2.9	0.1	2.7	2.5	—	—	1.1	2.4
Government	273.4	156.1	48.8	1.1	7.7	6.7	7.7	3.5	30.6	11.1
Federal	203.2	121.4	38.2	0.6	5.2	5.5	3.8	3.3	18.4	6.7
Medicare	117.8	73.9	30.5	0.0	4.1	4.2	0.1	3.1	1.9	—
Medicaid	54.3	25.2	5.3	0.5	0.3	1.3	3.5	—	15.3	2.9
Other	31.0	22.2	2.5	0.1	0.8	—	0.1	0.2	1.2	3.9
State and Local	70.2	34.7	10.6	0.5	2.5	1.2	3.9	0.1	12.3	4.4
Medicaid	35.3	12.5	3.8	0.4	0.3	1.2	2.7	—	12.2	2.2
Other	34.9	22.2	6.7	0.1	2.2	0.0	1.3	0.1	0.1	2.2
1992
Personal Health Care Expenditures	740.7	305.3	175.9	37.0	42.1	19.6	71.2	11.9	62.3	15.4
Out-of-Pocket Payments	161.8	13.7	33.7	17.8	15.2	5.0	45.0	7.3	24.1	—
Third-Party Payments	578.9	291.6	142.2	19.3	26.9	14.6	26.2	4.6	38.2	15.4
Private Health Insurance	250.6	107.2	86.8	17.7	14.8	2.9	17.9	0.7	2.6	—
Other Private	24.7	11.6	3.2	0.1	3.0	2.9	—	—	1.2	2.6
Government	303.6	172.8	52.3	1.4	9.0	8.8	8.3	3.9	34.4	12.7
Federal	230.5	138.7	40.4	0.8	6.3	7.4	4.2	3.8	21.2	7.8
Medicare	132.7	84.0	31.3	0.0	5.0	5.9	0.1	3.5	2.9	—
Medicaid	65.4	31.5	6.6	0.7	0.4	1.5	3.9	—	17.1	3.7
Other	32.4	23.2	2.5	0.1	0.9	—	0.2	0.2	1.3	4.1
State and Local	73.0	34.1	11.8	0.6	2.7	1.4	4.1	0.1	13.2	5.0
Medicaid	36.2	10.9	4.5	0.5	0.3	1.3	2.8	—	13.1	2.7
Other	36.9	23.2	7.3	0.1	2.4	0.1	1.3	0.1	0.1	2.3
1993
Personal Health Care Expenditures	$790.5	$323.0	$185.9	$39.5	$46.1	$23.0	$76.2	$12.3	$66.4	$18.0
Out-of-Pocket Payments	167.1	14.1	33.0	18.8	17.0	5.6	46.8	7.3	24.5	—
Third-Party Payments	623.5	308.9	153.0	20.7	29.1	17.4	29.5	5.0	41.9	18.0
Private Health Insurance	265.2	109.9	94.1	18.7	15.8	3.1	20.1	0.7	2.8	—
Other Private	26.8	12.7	3.3	0.2	3.4	3.2	—	—	1.2	2.8
Government	331.4	186.3	55.5	1.9	9.9	11.1	9.3	4.3	37.9	15.1
Federal	252.3	148.8	43.4	1.1	7.1	9.5	4.9	4.2	24.0	9.2
Medicare	144.7	90.1	33.2	0.0	5.7	7.7	0.2	3.9	3.9	—
Medicaid	73.5	34.3	7.7	1.0	0.6	1.8	4.6	—	18.7	5.0
Other	34.1	24.4	2.6	0.1	0.9	—	0.2	0.3	1.4	4.2
State and Local	79.1	37.5	12.1	0.8	2.8	1.5	4.4	0.1	13.9	5.9
Medicaid	42.2	14.1	5.0	0.7	0.5	1.5	3.2	—	13.8	3.5
Other	36.7	23.4	7.0	0.1	2.4	0.1	1.3	0.1	0.1	2.4
1994
Personal Health Care Expenditures	834.0	335.7	193.0	42.4	49.6	26.2	81.6	12.5	71.1	21.9
Out-of-Pocket Payments	168.5	12.7	31.4	20.0	18.3	5.9	47.8	7.2	25.3	—
Third-Party Payments	665.5	323.1	161.6	22.4	31.3	20.3	33.8	5.3	45.8	21.9
Private Health Insurance	274.5	108.6	98.9	20.2	16.4	3.3	23.5	0.6	3.0	—
Other Private	28.9	13.7	3.6	0.2	3.7	3.4	—	—	1.3	3.1
Government	362.0	200.8	59.1	2.0	11.1	13.7	10.4	4.6	41.4	18.8
Federal	275.7	159.9	46.8	1.1	8.3	11.9	5.4	4.5	26.5	11.3
Medicare	162.6	99.7	36.2	0.0	6.7	10.0	0.3	4.2	5.5	—
Medicaid	77.7	35.3	8.1	1.0	0.6	1.9	5.0	—	19.4	6.5
Other	35.4	24.9	2.5	0.1	0.9	—	0.2	0.3	1.5	4.9
State and Local	86.3	40.9	12.4	0.9	2.8	1.8	4.9	0.1	14.9	7.5
Medicaid	49.2	17.6	5.5	0.8	0.5	1.7	3.6	—	14.8	4.8
Other	37.0	23.4	6.8	0.1	2.4	0.1	1.3	0.1	0.1	2.7
1995
Personal Health Care Expenditures	879.3	347.2	201.9	45.0	53.6	29.1	88.9	13.1	75.5	25.1
Out-of-Pocket Payments	171.0	11.5	30.0	21.1	19.9	6.2	48.6	7.1	26.6	—
Third-Party Payments	708.3	335.7	171.8	23.9	33.7	22.9	40.4	6.0	48.8	25.1
Private Health Insurance	286.6	107.3	104.4	21.7	17.2	3.4	28.6	0.6	3.4	—
Other Private	31.6	14.9	4.2	0.2	4.1	3.5	—	—	1.4	3.3
Government	390.1	213.5	63.2	2.0	12.4	16.0	11.7	5.4	44.0	21.8
Federal	299.0	170.6	50.9	1.1	9.5	14.0	6.3	5.3	28.4	12.8
Medicare	180.7	108.9	39.9	0.0	7.8	11.9	0.4	5.0	6.7	—
Medicaid	82.0	36.2	8.5	1.0	0.8	2.1	5.6	—	20.1	7.9
Other	36.2	25.4	2.5	0.1	1.0	—	0.3	0.3	1.6	5.0
State and Local	91.2	42.9	12.4	0.9	2.9	1.9	5.4	0.1	15.6	9.0
Medicaid	55.2	20.5	6.0	0.8	0.6	1.8	4.1	—	15.5	6.0
Other	36.0	22.4	6.4	0.1	2.3	0.1	1.4	0.1	0.1	3.0
1996
Personal Health Care Expenditures	$924.0	$360.8	$208.5	$47.5	$57.5	$31.2	$98.3	$13.4	$79.4	$27.4
Out-of-Pocket Payments	178.1	11.8	31.1	22.1	21.9	6.5	51.0	6.9	26.7	—
Third-Party Payments	745.9	348.9	177.4	25.5	35.5	24.7	47.3	6.5	52.7	27.4
Private Health Insurance	299.8	110.0	106.9	23.2	18.0	3.5	33.9	0.6	3.7	—
Other Private	33.5	16.1	4.3	0.2	4.3	3.7	—	—	1.5	3.4
Government	412.6	222.8	66.2	2.1	13.2	17.5	13.4	5.9	47.4	24.0
Federal	319.8	179.6	54.4	1.2	10.4	15.5	7.5	5.8	31.3	14.1
Medicare	194.9	116.3	42.8	0.1	8.4	13.2	0.7	5.4	8.0	—
Medicaid	88.0	37.4	9.1	1.0	0.9	2.3	6.5	—	21.6	9.2
Other	37.0	25.9	2.6	0.2	1.0	—	0.3	0.3	1.7	5.0
State and Local	92.8	43.2	11.8	0.9	2.8	2.0	5.9	0.1	16.2	9.9
Medicaid	58.4	21.6	6.1	0.8	0.7	1.9	4.6	—	16.0	6.7
Other	34.5	21.6	5.7	0.1	2.2	0.1	1.3	0.1	0.1	3.2
1997
Personal Health Care Expenditures	969.0	371.1	217.6	50.6	61.9	32.3	108.9	13.9	82.8	29.9
Out-of-Pocket Payments	187.6	12.4	34.1	23.9	24.6	7.0	53.0	6.8	25.7	—
Third-Party Payments	781.5	358.6	183.6	26.8	37.3	25.3	55.9	7.1	57.0	29.9
Private Health Insurance	313.5	113.0	109.1	24.3	18.9	3.7	39.9	0.5	4.0	—
Other Private	35.6	17.2	4.3	0.2	4.8	3.9	—	—	1.6	3.6
Government	432.4	228.4	70.1	2.3	13.6	17.7	16.0	6.6	51.4	26.3
Federal	337.3	185.6	58.4	1.3	10.8	15.4	9.2	6.4	34.5	15.6
Medicare	208.9	123.7	46.4	0.1	8.8	12.8	1.0	6.0	10.1	—
Medicaid	91.1	36.2	9.3	1.1	1.0	2.6	7.8	—	22.6	10.4
Other	37.3	25.7	2.7	0.1	1.1	—	0.4	0.4	1.7	5.1
State and Local	95.1	42.8	11.7	1.0	2.8	2.3	6.8	0.1	16.9	10.7
Medicaid	61.2	21.4	6.4	0.9	0.7	2.1	5.5	—	16.8	7.5
Other	33.9	21.4	5.3	0.1	2.1	0.1	1.4	0.1	0.1	3.3

NOTES: The figure 0.0 denotes amounts less than $50 million. Medicaid expenditures exclude Part B premium payments to Medicare by States under buy-in agreements to cover premiums for eligible Medicaid recipients. Numbers may not add to totals because of rounding.

SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.