National health expenditures, 1999.

The health care spending share of gross domestic product (GDP) remained steady between 1993 and 1999 as moderate-to-strong economic growth coincided with a rapid shift to managed care. This shift, along with decelerating growth in Medicare spending, appears to have generated a mostly one-time saving that lowered aggregate health expenditure growth.

Introduction

In this article, we present historical health spending in the United States using a matrix structure to describe trends in the size, growth, and distribution of health care expenditures for the period 1960-1999. This matrix represents spending in current dollars by type of service, such as hospital care and physician and clinical services, matched against the sources that pay for the health care bill, including private health insurance (PHI), and government programs such as Medicare and Medicaid. The statistics that are shown on the matrix provide a historical basis for policymakers, researchers, and the public to understand the trends in spending for the health industry and to lay a foundation for projections of health care spending (Heffler et al., 2001).

In the figures that follow, we present information on health care spending, focusing on calendar year 1999. The figures include estimates of total health spending, spending by sources of funds (Medicaid, Medicare, and PHI), and spending for hospitals, physician and clinical services, other professional services, prescription drugs, home health care, and nursing home services. Also included in this article is a Technical Note explaining methodological changes that were incorporated in the 1999 national health expenditures (NHE).

Tables 1-3 provide detailed NHE information for selected calendar years by type of service and source of funds. The format of these tables differs slightly from those published previously in that prescription drugs now appear as a separate category, and the various services have been realigned into broad subcategories. More complete time-series estimates and an updated definitions and methodologies can be found online at: http://cms.hhs.gov/stats/nhe-oact/.

Table 1

National Health Expenditures Aggregate and per Capita Amounts, Percent Distribution, and Average Annual Percent Growth, by Source of Funds: Selected Calendar Years 1980-1999

Item	1980	1988	1990	1993	1994	1995	1996	1997	1998	1999
	Amount in Billions
National Health Expenditures	$245.8	$557.5	$695.6	$887.6	$936.7	$987.0	$1,038.0	$1,093.9	$1,146.1	$1,210.7
Private	141.0	331.2	413.2	497.3	509.4	528.8	553.6	588.0	623.2	662.1
Public	104.8	226.3	282.4	390.3	427.3	458.2	484.4	505.8	522.9	548.5
Federal	71.3	154.0	192.6	274.2	298.7	323.9	346.6	361.7	369.3	384.7
State and Local	33.5	72.3	89.8	116.1	128.6	134.3	137.8	144.2	153.6	163.9
	Number in Millions
U.S. Population1	230	249	254	263	265	268	270	273	275	278
	Amount in Billions
Gross Domestic Product	$2,796	$5,108	$5,803	$6,642	$7,054	$7,400	$7,813	$8,318	$8,790	$9,299
	Per Capita Amount
National Health Expenditures	$1,067	$2,240	$2,737	$3,379	$3,532	$3,686	$3,842	$4,011	$4,164	$4,358
Private	612	1,331	1,626	1,893	1,921	1,975	2,049	2,156	2,264	2,384
Public	455	909	1,111	1,486	1,611	1,711	1,793	1,855	1,900	1,975
Federal	309	619	758	1,044	1,126	1,210	1,283	1,326	1,342	1,385
State and Local	146	291	353	442	485	502	510	529	558	590
	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	57.4	59.4	59.4	56.0	54.4	53.6	53.3	53.8	54.4	54.7
Public	42.6	40.6	40.6	44.0	45.6	46.4	46.7	46.2	45.6	45.3
Federal	29.0	27.6	27.7	30.9	31.9	32.8	33.4	33.1	32.2	31.8
State and Local	13.6	13.0	12.9	13.1	13.7	13.6	13.3	13.2	13.4	13.5
	Percent of Gross Domestic Product
National Health Expenditures	8.8	10.9	12.0	13.4	13.3	13.3	13.3	13.2	13.0	13.0
	Average Annual Percent Growth from Previous Year Shown
National Health Expenditures	211.7	10.8	11.7	8.5	5.5	5.4	5.2	5.4	4.8	5.6
Private	210.2	11.3	11.7	6.4	2.4	3.8	4.7	6.2	6.0	6.2
Public	214.8	10.1	11.7	11.4	9.5	7.2	5.7	4.4	3.4	4.9
Federal	217.5	10.1	11.8	12.5	8.9	8.4	7.0	4.4	2.1	4.2
State and Local	211.5	10.1	11.5	8.9	10.8	4.4	2.6	4.6	6.5	6.7
U.S. Population	21.1	1.0	1.1	1.1	1.0	1.0	0.9	0.9	0.9	0.9
Gross Domestic Product	28.7	7.8	6.6	4.6	6.2	4.9	5.6	6.5	5.7	5.8

July 1 census resident-based population estimates for each year 1980-1999.

Average annual growth between 1960 and 1980.

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

SOURCES: Centers for Medicare & Medicaid Services, Office of the Actuary: National Health Statistics Group; U.S. Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census.

Table 3

National Health Expenditures, by Source of Funds and Type of Expenditure: Selected Calendar Years 1994-1999

Year and Type of Expenditure	Total	Private				Public			Medicare1	Medicaid2,3
		Total Private	Consumer		Other
			Out-of-Pocket Payments	Private Health Insurance		Total	Federal	State and Local
	Amount in Billions
1994
National Health Expenditures	$936.7	$509.4	$146.2	$308.9	$54.3	$427.3	$298.7	$128.6	$166.2	$133.7
Health Services and Supplies	904.2	495.9	146.2	308.9	40.8	408.3	285.3	123.0	166.2	133.7
Personal Health Care	816.5	455.7	146.2	269.3	40.2	360.8	273.2	87.6	162.0	126.0
Hospital Care	332.4	135.1	11.0	110.8	13.2	197.3	156.8	40.5	99.1	52.0
Professional Services	297.5	207.2	53.9	131.6	21.7	90.3	66.4	23.9	41.3	27.5
Physician and Clinical	210.4	145.9	28.0	101.8	16.2	64.5	51.7	12.8	38.0	13.7
Other Professional	25.7	18.7	7.0	9.3	2.4	6.9	4.1	2.8	3.3	0.9
Dental	41.4	39.5	18.9	20.5	0.1	2.0	1.1	0.9	0.0	1.7
Other Personal Health Care	20.0	3.1	—	—	3.1	16.9	9.5	7.4	—	11.2
Nursing Home and Home Health	94.4	36.2	23.0	8.0	5.2	58.1	40.1	18.1	17.1	37.9
Home Health Care	26.1	9.4	4.5	3.7	1.2	16.6	13.4	3.2	11.3	3.8
Nursing Home Care	68.3	26.8	18.5	4.3	4.1	41.5	26.7	14.9	5.8	34.1
Retail Outlet Sales of Medical Products	92.2	77.2	58.3	18.9	—	15.0	9.9	5.1	4.4	8.6
Prescription Drugs	54.6	43.9	27.3	16.7	—	10.7	5.7	5.0	0.5	8.6
Other Medical Products	37.6	33.2	31.0	2.3	—	4.3	4.2	0.1	3.9	—
Durable Medical Equipment	13.3	9.9	7.6	2.3	—	3.4	3.3	0.1	3.0	—
Other Non-Durable Medical Products	24.3	23.3	23.3	—	—	0.9	0.9	—	0.9	—
Government Administration and Net Cost of Private Health Insurance	57.7	40.2	—	39.6	0.6	17.5	8.5	9.1	4.3	7.7
Government Public Health Activities	30.0	—	—	—	—	30.0	3.6	26.4	—	—
Investment	32.5	13.5	—	—	13.5	19.0	13.4	5.6	—	—
Research4	16.3	1.4	—	—	1.4	14.8	12.5	2.3	—	—
Construction	16.2	12.1	—	—	12.1	4.2	0.9	3.3	—	—
1995
National Health Expenditures	$987.0	$528.8	$149.2	$322.3	$57.3	$458.2	$323.9	$134.3	$184.8	$144.1
Health Services and Supplies	954.4	516.3	149.2	322.3	44.8	438.1	309.6	128.5	184.8	144.1
Personal Health Care	865.7	478.3	149.2	285.0	44.1	387.4	296.7	90.7	180.3	135.0
Hospital Care	343.6	136.1	10.5	111.0	14.6	207.5	167.4	40.1	108.5	54.3
Professional Services	316.5	217.9	54.1	140.2	23.5	98.6	72.8	25.8	45.4	31.4
Physician and Clinical	220.5	151.1	26.3	107.3	17.6	69.4	56.1	13.2	41.7	14.8
Other Professional	28.5	21.1	7.7	10.7	2.6	7.5	4.6	2.9	3.7	1.0
Dental	44.5	42.4	20.1	22.2	0.1	2.0	1.1	0.9	0.0	1.8
Other Personal Health Care	23.0	3.3	—	—	3.3	19.8	10.9	8.8	--	13.8
Nursing Home and Home Health	105.1	41.0	25.2	9.8	6.0	64.1	45.0	19.1	21.1	39.7
Home Health Care	30.5	10.8	5.3	4.3	1.2	19.7	16.2	3.5	13.9	4.2
Nursing Home Care	74.6	30.2	19.9	5.6	4.8	44.4	28.8	15.6	7.2	35.4
Retail Outlet Sales of Medical Products	100.5	83.4	59.4	24.0	—	17.2	11.5	5.7	5.4	9.7
Prescription Drugs	60.8	48.7	27.2	21.4	—	12.1	6.6	5.5	0.8	9.7
Other Medical Products	39.7	34.7	32.1	2.6	—	5.0	4.9	0.1	4.6	—
Durable Medical Equipment	14.2	10.2	7.7	2.6	—	4.0	3.8	0.1	3.5	—
Other Non-Durable Medical Products	25.6	24.5	24.5	—	—	1.1	1.1	—	1.1	—
Government Administration and Net Cost of Private Health Insurance	57.2	38.0	—	37.3	0.7	19.3	9.3	10.0	4.5	9.1
Government Public Health Activities	31.4	—	—	—	—	31.4	3.6	27.8	—	—
Investment	32.6	12.5	—	—	12.5	20.1	14.3	5.8	—	—
Research4	17.1	1.4	—	—	1.4	15.7	13.2	2.5	—	—
Construction	15.5	11.1	—	—	11.1	4.4	1.1	3.3	—	—
1996
National Health Expenditures	$1,038.0	$553.6	$155.0	$337.4	$61.1	$484.4	$346.6	$137.8	$200.3	$152.2
Health Services and Supplies	1,003.8	540.4	155.0	337.4	47.9	463.4	331.8	131.6	200.3	152.2
Personal Health Care	911.9	500.4	155.0	298.2	47.2	411.5	318.1	93.4	195.1	144.3
Hospital Care	355.9	137.7	10.4	111.5	15.8	218.2	177.5	40.6	117.4	56.8
Professional Services	332.9	228.0	56.1	146.7	25.2	104.9	78.1	26.8	48.1	34.4
Physician and Clinical	229.3	156.9	27.0	111.1	18.8	72.4	59.0	13.4	44.2	15.6
Other Professional	30.9	23.0	8.2	11.9	2.8	7.9	4.9	3.0	3.9	1.2
Dental	46.8	44.7	20.9	23.6	0.1	2.1	1.2	0.9	0.1	1.9
Other Personal Health Care	25.9	3.4	—	—	3.4	22.5	13.0	9.5	—	15.7
Nursing Home and Home Health	113.5	44.2	26.4	11.5	6.3	69.3	49.4	19.9	23.5	42.3
Home Health Care	33.6	12.5	6.3	4.9	1.3	21.1	17.4	3.7	14.9	4.5
Nursing Home Care	79.9	31.7	20.1	6.6	4.9	48.2	32.0	16.2	8.7	37.8
Retail Outlet Sales of Medical Products	109.5	90.4	62.0	28.4	—	19.1	13.0	6.1	6.0	10.9
Prescription Drugs	67.2	53.5	27.9	25.6	—	13.7	7.7	6.0	1.1	10.9
Other Medical Products	42.4	37.0	34.1	2.8	—	5.4	5.3	0.1	4.9	—
Durable Medical Equipment	15.3	11.0	8.1	2.8	—	4.3	4.2	0.1	3.9	—
Other Non-Durable Medical Products	27.1	26.0	26.0	—	—	1.1	1.1	—	1.1	—
Government Administration and Net Cost of Private Health Insurance	59.0	40.0	—	39.3	0.7	19.0	10.0	9.0	5.2	7.9
Government Public Health Activities	32.9	—	—	—	—	32.9	3.8	29.2	—	—
Investment	34.2	13.2	—	—	13.2	21.0	14.8	6.3	—	—
Research4	17.8	1.6	—	—	1.6	16.2	13.6	2.7	—	—
Construction	16.4	11.6	—	—	11.6	4.8	1.2	3.6	—	—
1997
National Health Expenditures	$1,093.9	$588.0	$165.5	$355.6	$66.9	$505.8	$361.7	$144.2	$211.2	$159.8
Health Services and Supplies	1,056.5	573.1	165.5	355.6	52.0	483.3	346.0	137.3	211.2	159.8
Personal Health Care	958.8	530.6	165.5	313.8	51.3	428.2	331.5	96.7	205.6	151.7
Hospital Care	367.7	142.8	11.0	113.9	17.9	224.8	183.5	41.4	124.1	58.0
Professional Services	352.4	242.0	61.2	154.0	26.8	110.4	82.9	27.5	51.5	36.7
Physician and Clinical	240.9	165.1	28.7	116.2	20.1	75.9	62.6	13.3	47.4	16.2
Other Professional	33.4	25.4	9.4	13.0	3.0	8.0	5.0	3.0	4.0	1.3
Dental	50.2	47.9	23.0	24.8	0.1	2.2	1.3	1.0	0.1	2.0
Other Personal Health Care	27.9	3.6	—	—	3.6	24.3	14.0	10.3	—	17.2
Nursing Home and Home Health	119.6	48.0	28.9	12.6	6.6	71.6	50.5	21.0	23.3	44.7
Home Health Care	34.5	14.6	7.5	5.6	1.4	19.9	16.1	3.9	13.3	4.9
Nursing Home Care	85.1	33.4	21.4	6.9	5.1	51.6	34.5	17.2	10.0	39.8
Retail Outlet Sales of Medical Products	119.2	97.7	64.4	33.3	—	21.5	14.7	6.8	6.7	12.3
Prescription Drugs	75.1	59.6	29.2	30.3	—	15.5	8.9	6.7	1.3	12.3
Other Medical Products	44.0	38.1	35.2	2.9	—	5.9	5.8	0.1	5.4	—
Durable Medical Equipment	16.2	11.4	8.5	2.9	—	4.8	4.7	0.1	4.3	—
Other Non-Durable Medical Products	27.9	26.7	26.7	—	—	1.2	1.2	—	1.2	—
Government Administration and Net Cost of Private Health Insurance	61.6	42.6	—	41.8	0.8	19.1	10.6	8.5	5.6	8.1
Government Public Health Activities	36.0	—	—	—	—	36.0	3.9	32.1	—	—
Investment	37.4	14.9	—	—	14.9	22.5	15.6	6.9	—	—
Research4	18.7	1.6	—	—	1.6	17.1	14.3	2.8	—	—
Construction	18.7	13.3	—	—	13.3	5.4	1.3	4.1	—	—
1998
National Health Expenditures	$1,146.1	$623.2	$176.1	$376.8	$70.3	$522.9	$369.3	$153.6	$211.4	$171.7
Health Services and Supplies	1,107.9	607.7	176.1	376.8	54.8	500.2	352.8	147.4	211.4	171.7
Personal Health Care	1,002.3	563.2	176.1	333.2	53.8	439.1	335.8	103.3	205.2	160.3
Hospital Care	377.1	151.2	11.8	119.5	19.9	225.9	181.5	44.5	121.8	60.8
Professional Services	373.4	255.0	65.1	161.8	28.1	118.4	89.3	29.0	55.5	39.1
Physician and Clinical	254.2	172.9	29.9	121.9	21.1	81.3	67.7	13.7	51.3	16.7
Other Professional	35.9	27.6	10.7	13.8	3.1	8.2	5.2	3.1	4.1	1.3
Dental	53.1	50.7	24.5	26.1	0.1	2.3	1.4	1.0	0.1	2.1
Other Personal Health Care	30.2	3.8	—	—	3.8	26.5	15.1	11.3	—	19.0
Nursing Home and Home Health	121.6	50.9	31.8	13.3	5.8	70.7	48.8	21.9	20.9	46.1
Home Health Care	33.5	16.1	8.5	6.1	1.5	17.4	13.3	4.1	10.3	5.4
Nursing Home Care	88.0	34.8	23.2	7.2	4.3	53.3	35.5	17.7	10.7	40.7
Retail Outlet Sales of Medical Products	130.2	106.1	67.4	38.7	—	24.1	16.1	8.0	7.0	14.4
Prescription Drugs	85.2	66.9	31.3	35.7	—	18.2	10.4	7.8	1.7	14.4
Other Medical Products	45.0	39.2	36.2	3.0	—	5.8	5.7	0.1	5.3	—
Durable Medical Equipment	16.3	11.7	8.6	3.0	—	4.6	4.5	0.1	4.1	—
Other Non-Durable Medical Products	28.7	27.5	27.5	—	—	1.2	1.2	—	1.2	—
Government Administration and Net Cost of Private Health Insurance	67.0	44.5	—	43.6	0.9	22.5	13.0	9.5	6.2	11.5
Government Public Health Activities	38.6	—	—	—	—	38.6	4.0	34.6	—	—
Investment	38.2	15.5	—	—	15.5	22.7	16.5	6.2	—	—
Research4	20.5	2.0	—	—	2.0	18.6	15.5	3.1	—	—
Construction	17.7	13.6	—	—	13.6	4.1	1.0	3.1	—	—
1999
National Health Expenditures	$1,210.7	$662.1	$186.5	$401.2	$74.4	$548.5	$384.7	$163.9	$213.6	$186.9
Health Services and Supplies	1,170.8	646.6	186.5	401.2	58.9	524.2	366.9	157.4	213.6	186.9
Personal Health Care	1,057.7	599.7	186.5	355.3	57.9	458.0	347.2	110.8	205.9	174.2
Hospital Care	390.9	158.4	12.6	124.1	21.7	232.6	185.2	47.3	121.4	66.5
Professional Services	396.5	269.0	67.7	171.3	30.1	127.5	96.2	31.3	58.9	42.7
Physician and Clinical	269.4	182.2	30.7	128.6	22.9	87.2	72.8	14.4	54.7	17.7
Other Professional	37.9	29.4	11.4	14.9	3.1	8.5	5.2	3.2	4.1	1.4
Dental	56.0	53.5	25.6	27.7	0.1	2.6	1.5	1.0	0.1	2.2
Other Personal Health Care	33.2	4.0	—	—	4.0	29.3	16.6	12.6	—	21.4
Nursing Home and Home Health	123.1	52.8	32.9	13.8	6.2	70.3	47.5	22.8	18.4	48.0
Home Health Care	33.1	16.9	9.0	6.3	1.7	16.1	11.9	4.2	8.7	5.6
Nursing Home Care	90.0	35.9	23.9	7.5	4.5	54.1	35.6	18.6	9.6	42.4
Retail Outlet Sales of Medical Products	147.1	119.5	73.4	46.1	—	27.6	18.3	9.4	7.3	17.1
Prescription Drugs	99.6	77.9	34.9	43.0	—	21.7	12.4	9.2	2.0	17.1
Other Medical Products	47.6	41.6	38.4	3.2	—	6.0	5.8	0.1	5.4	—
Durable Medical Equipment	16.9	12.1	8.9	3.2	—	4.8	4.6	0.1	4.2	—
Other Non-Durable Medical Products	30.7	29.5	29.5	—	—	1.2	1.2	—	1.2	—
Government Administration and Net Cost of Private Health Insurance	72.0	46.9	—	45.9	1.0	25.1	15.3	9.8	7.6	12.7
Government Public Health Activities	41.1	—	—	—	—	41.1	4.4	36.8	—	—
Investment	39.8	15.5	—	—	15.5	24.3	17.8	6.5	—	—
Research4	22.2	2.1	—	—	2.1	20.1	16.9	3.2	—	—
Construction	17.6	13.4	—	—	13.4	4.2	0.9	3.3	—	—

Subset of Federal funds.

Subset of Federal and State and local funds.

Excludes State Children's Health Insurance Program (SCHIP) and Medicaid SCHIP expansion.

Research and development expenditures of drug companies and other manufacturers and providers of medical equipment and supplies are excluded from research expenditures. These research expenditures are implicitly included in the expenditure class in which the product falls in that they are covered by the payment received for that product.

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

SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group.

Conclusion

NHE maintained an unprecedented stable share of GDP for the period 1993 to 1999. Robust GDP growth, low economy-wide inflation, increased enrollment in managed care plans that has dampened health spending growth, and recent legislation affecting Medicare spending have all contributed to this stable share. However, there are indications that this recent period of stabilization is about to change. In 1999, NHE growth accelerated slightly, driven by increased spending growth for prescription drugs, increased PHI premiums, and increased Medicaid spending. Projections of health care spending show that health care will again be consuming a larger portion of national economic resources in 2000, a trend that will continue through 2010 (Heffler et al., 2001).

Technical Note

Estimates of NHE periodically undergo major revisions to incorporate new concepts, methods, and data sources. Several major conceptual revisions were incorporated into the current estimates of NHE, including the redefinition of several service categories as a result of the adoption of the North American Industrial Classification System, which replaced the Standard Industrial Classification System previously used governmentwide to collect economic data by industry. Other conceptual revisions include the elimination of small amounts of spending occurring outside the United States, the introduction of new data, and the associated methodological revisions needed to incorporate this information. Historical estimates incorporate recently released 1997 information from the U.S. Census Bureau's 1997 Economic Census: Health Care and Social Assistance Subject Series and data from the Agency for Healthcare Research and Quality's 1996 Medical Expenditure Panel Survey.

Because of these new data sources and a general realignment of the accounting structure, several service categories have been redefined. One major change has been our expansion of physician services to include services provided in both physician offices and outpatient care facilities. Because the services offered in physician offices are often indistinguishable from those provided in outpatient care facilities, these categories have been merged. Similarly, the source-of-funds data that were gathered did not, in most cases, differentiate between the two types of care.

Another change to the NHE included limiting the other professional service category to only licensed other professionals, such as chiropractors, optometrists, therapists, and podiatrists. Miscellaneous other health care services, an industry whose primary component was blood banks, are no longer included in the NHE because the cost of blood products is incorporated in the receipts/revenues of the institutions providing the blood to the patient.

A full discussion of the definitions and methodologies used to generate these estimates is available at http://cms.hhs.gov/stats/nhe-oact/lessons/.

Table 2

National Health Expenditures Aggregate Amounts and Average Annual Percent Change, by Type of Expenditure: Selected Calendar Years 1980-1999

Type of Expenditure	11980	1988	1990	1993	1994	1995	1996	1997	1998	1999
	Amount in Billions
National Health Expenditures	$245.8	$557.5	$695.6	$887.6	$936.7	$987.0	$1,038.0	$1,093.9	$1,146.1	$1,210.7
Health Services and Supplies	233.5	534.8	669.2	855.8	904.2	954.4	1,003.8	1,056.5	1,107.9	1,170.8
Personal Health Care	214.6	493.3	609.4	775.8	816.5	865.7	911.9	958.8	1,002.3	1,057.7
Hospital Care	101.5	209.4	253.9	320.0	332.4	343.6	355.9	367.7	377.1	390.9
Professional Services	67.3	176.3	216.9	280.8	297.5	316.5	332.9	352.4	373.4	396.5
Physician and Clinical	47.1	127.4	157.5	201.2	210.4	220.5	229.3	240.9	254.2	269.4
Other Professional	3.6	14.3	18.2	24.5	25.7	28.5	30.9	33.4	35.9	37.9
Dental	13.3	27.3	31.5	38.9	41.4	44.5	46.8	50.2	53.1	56.0
Other Personal Health Care	3.3	7.3	9.7	16.2	20.0	23.0	25.9	27.9	30.2	33.2
Nursing Home and Home Health	20.1	48.9	65.3	87.6	94.4	105.1	113.5	119.6	121.6	123.1
Home Health Care	2.4	8.4	12.6	21.9	26.1	30.5	33.6	34.5	33.5	33.1
Nursing Home Care	17.7	40.5	52.7	65.7	68.3	74.6	79.9	85.1	88.0	90.0
Retail Outlet Sales of Medical Products	25.7	58.7	73.3	87.5	92.2	100.5	109.5	119.2	130.2	147.1
Prescription Drugs	12.0	30.6	40.3	51.3	54.6	60.8	67.2	75.1	85.2	99.6
Other Medical Products	13.7	28.1	33.1	36.2	37.6	39.7	42.4	44.0	45.0	47.6
Durable Medical Equipment	3.9	8.7	10.6	12.8	13.3	14.2	15.3	16.2	16.3	16.9
Other Non-Durable Medical Products	9.8	19.4	22.5	23.4	24.3	25.6	27.1	27.9	28.7	30.7
Government Administration and Net Cost of Private Health Insurance	12.2	26.0	39.6	52.8	57.7	57.2	59.0	61.6	67.0	72.0
Government Public Health Activities	6.7	15.5	20.2	27.2	30.0	31.4	32.9	36.0	38.6	41.1
Investment	12.3	22.7	26.4	31.8	32.5	32.6	34.2	37.4	38.2	39.8
Research2	5.5	10.8	12.7	15.6	16.3	17.1	17.8	18.7	20.5	22.2
Construction	6.8	11.9	13.7	16.2	16.2	15.5	16.4	18.7	17.7	17.6
	Average Annual Percent Change from Previous Year Shown
National Health Expenditures	11.7	10.8	11.7	8.5	5.5	5.4	5.2	5.4	4.8	5.6
Health Services and Supplies	11.8	10.9	11.9	8.5	5.7	5.5	5.2	5.3	4.9	5.7
Personal Health Care	11.7	11.0	11.1	8.4	5.2	6.0	5.3	5.1	4.5	5.5
Hospital Care	12.8	9.5	10.1	8.0	3.9	3.4	3.6	3.3	2.6	3.7
Professional Services	11.0	12.8	10.9	9.0	5.9	6.4	5.2	5.8	6.0	6.2
Physician and Clinical	11.5	13.2	11.2	8.5	4.6	4.8	4.0	5.1	5.5	6.0
Other Professional	11.7	18.8	12.7	10.4	4.8	11.3	8.2	8.1	7.5	5.6
Dental	10.0	9.4	7.4	7.3	6.6	7.4	5.2	7.2	5.8	5.6
Other Personal Health Care	8.6	10.5	15.2	18.7	23.2	15.2	12.5	7.6	8.6	9.9
Nursing Home and Home Health	16.8	11.8	15.5	10.3	7.8	11.3	8.0	5.4	1.6	1.3
Home Health Care	20.6	17.1	22.1	20.3	19.1	17.1	10.1	2.8	-3.0	-1.4
Nursing Home Care	16.4	10.9	14.1	7.6	4.0	9.1	7.1	6.5	3.5	2.3
Retail Outlet Sales of Medical Products	8.6	10.9	11.8	6.0	5.4	9.0	9.0	8.8	9.2	13.0
Prescription Drugs	7.8	12.4	14.7	8.4	6.6	11.2	10.5	11.9	13.4	16.9
Other Medical Products	9.4	9.4	8.5	3.1	3.7	5.8	6.6	3.9	2.2	5.7
Durable Medical Equipment	9.3	10.7	10.4	6.5	4.1	6.5	7.8	5.8	0.7	3.6
Other Non-Durable Medical Products	9.4	8.9	7.7	1.4	3.6	5.4	6.0	2.9	3.0	6.9
Government Administration and Net Cost of Private Health Insurance	12.2	10.0	23.5	10.1	9.4	-0.8	3.0	4.5	8.7	7.4
Government Public Health Activities	15.3	11.0	14.2	10.4	10.3	4.7	4.7	9.5	7.1	6.6
Investment	10.4	8.0	7.8	6.4	2.1	0.3	5.1	9.3	2.2	4.1
Research2	10.9	8.9	8.2	7.2	4.3	5.2	4.3	5.0	9.8	8.2
Construction	10.0	7.2	7.4	5.7	0.1	-4.5	5.9	14.0	-5.3	-0.6

Average annual growth between 1960 and 1980.

Research and development expenditures of drug companies and other manufacturers and providers of medical equipment and supplies are excluded from research expenditures. These research expenditures are implicitly included in the expenditure class in which the product falls in that they are covered by the payment received for that product.

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

SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group.