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Citizen Brief

Cost of Health Care 

Citizens4health vision

The cost of care is affordable to individuals, businesses, and government. Individuals, businesses and the government will share responsibility for covering healthcare costs.


Goal: By November 2021 the cost of healthcare services is affordable and sustainable for individuals, businesses, and government.

The Health of the Nation Metrics:

What is the cost of healthcare for the nation? VA, Medicare, Medicaid, tax-exempt employer-provided healthcare?

What are the projected costs for federal healthcare expenditures?

What is the cost of healthcare to individuals and businesses?

Improving the prognosis of health care in the USA, Lancet February 15, 2020

Although health care expenditure per capita is higher in the USA than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have inadequate access to care. Efforts are ongoing to repeal the Affordable Care Act which would exacerbate health-care inequities. By contrast, a universal system, such as that proposed in the Medicare for All Act, has the potential to transform the availability and efficiency of American health-care services. Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to single-payer health care would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring health-care access for all Americans would save more than 68 000 lives and 1·73 million life-years every year compared with the status quo.

Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses


In this systematic review, we found a high degree of analytic consensus for the fiscal feasibility of a single-payer approach in the US. Actual costs will depend on plan features and implementation. Future research should refine estimates of the effects of coverage expansion on utilization, evaluate provider administrative costs in varied existing single-payer systems, analyze implementation options, and evaluate US-based single-payer programs, as available

Would ‘Medicare for All’ Save Billions or Cost Billions?


The Basics of ‘Medicare for All’

What to know about Bernie Sanders’s health care plan, plus further reading for the nerds among you.

The nation spent upwards of $3.5 trillion on medical services this year


This year’s federal deficit is over $1.3 trillion and the national debt is at $13.9 trillion

  • Data associated with the cost per type of service (Link to Medicare and various insurance companies pricing)

  • Data associated with the cost per common conditions

  • Healthcare obligations (Medicare, states, company pension plans, etc)

  • Healthcare expenditures in the US

    • federal

    • state and local

    • employers

    • others

  •  US debt

1.      Gross Debt is the sum of publicly-held and intragovernmental debt. Since May 16, gross debt subject to the debt limit has totaled $14.294 trillion.

2.      Publicly-held  Debt includes all federal debt held by private investors—including individuals, corporations and foreign governments. As of June 24, publicly –held debt totaled $9.74 trillion


3.      Intragovernmental Debt includes the debt that the Treasury owes to accounts within the federal government. Much of this debt results from the surplus in the Social Security trust fund, which is required by law to be invested in federal securities

  • Intragovernmental debt amounted to $4.61 trillion as of June 24.


Our analysis of monthly data on health care spending shows that the moderation in growth began well before the recession and has continued through May 2012. Spending estimates are based on monthly data from the Bureau of Economic Analysis (BEA), transformed for consistency with the official annual figures from the National Health Expenditure Accounts (NHEA). Since the NHEA runs through 2010, our monthly estimates for 2011 and 2012 are based on BEA data, adjusted according to the historical relationship between BEA and NHEA figures (see the Supplementary Appendix, available with the full text of this article at

Cost of employer-provided insurance

Each year in the United States, chronic disease such as heart disease, stroke, cancer, and diabetes cause 7 in 10 deaths and account for about 75% of the $2 trillion spent on medical care9


In 2009, the economic costs of cardiovascular diseases and stroke were estimated at $475.3 billion, including $313.8 billion in direct medical expenses and $161.5 billion in indirect costs ($39.1 in lost productivity due to sickness or disability and $122.4 lost productivity due to premature death)10


In 2007, medical costs attributed to diabetes included $27 billion for care to directly treat diabetes, $58 billion to treat diabetes-related chronic complications attributable to diabetes, and $31 billion in excess general medical costs11


In 2008, the estimated health care costs related to obesity were $147 billion12


Almost every conversation about US healthcare is dominated by concerns about unsustainable costs. We spend far more, per capita, on healthcare than any other country in the world — more than $8,000, compared with $3,000 in Japan, for example — yet obesity, asthma, mental health, and other chronic diseases are increasing burdens. On the other hand, we spend much less on social services: for every healthcare dollar spent from 2000 to 2009, the US spent about 90 cents on social services, compared with $2 among peer countries in the Organisation for Economic Cooperation and Development. Could this be the real source of poor health in the US and should it reframe our spending discussion? How might we pursue evidence-based, health-promoting strategies?

Speakers:Elizabeth Bradley, Julie Rovner

Festival: 2015

The politics of health care are messy. Obamacare is haunted by myths. And that's why Harvard's Kate Baicker — a former White House economist and one of the nation's most acclaimed researchers — is so focused on using evidence, not anecdotes, to shape America's health policies.

Baicker talks about building a career in research (starts at the 1:55 minute mark), her pioneering work with the Oregon Health Insurance Experiment (8:45), what she thinks of Obamacare’s cost controls and President Obama’s pitch for a public option (24:30), whether the ACA did enough to bend the cost curve (34:00), and what beltway pundits get wrong about health policy (41:30).


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