Freeland M S, Schendler C E
Health Care Financ Rev. 1983 Mar;4(3):1-58.
Health care spending in the United States more than tripled between 1971 and 1981, increasing from $83 billion to $287 billion. This growth in health sector spending substantially outpaced overall growth in the economy, averaging 13.2 percent per year compared to 10.5 percent for the gross national product (GNP). By 1981, one out of every ten dollars of GNP was spent on health care, compared to one out of every thirteen dollars of GNP in 1971. If current trends continue and if present health care financing arrangements remain basically unchanged, national health expenditures are projected to reach approximately $756 billion in 1990 and consume roughly 12 percent of GNP. The focal issue in health care today is cost and cost increases. The outlook for the 1980's is for continued rapid growth but at a diminished rate. The primary force behind this moderating growth is projected lower inflation. However, real growth rates are also expected to moderate slightly. The chief factors influencing the growth of health expenditures in the eighties are expected to be aging of the population, new medical technologies, increasing competition, restrained public funding, growth in real income, increased health manpower, and a deceleration in economy-wide inflation. Managers, policy makers and providers in the health sector, as in all sectors, must include in today's decisions probable future trends. Inflation, economic shocks, and unanticipated outcomes of policies over the last decade have intensified the need for periodic assessments of individual industries and their relationship to the macro economy. This article provides such an assessment for the health care industry. Baseline current-law projections of national health expenditures are made to 1990.
1971年至1981年间,美国医疗保健支出增长了两倍多,从830亿美元增至2870亿美元。医疗保健行业支出的增长速度大大超过了整体经济的增长速度,年平均增长率为13.2%,而国民生产总值(GNP)的年平均增长率为10.5%。到1981年,每10美元的国民生产总值中就有1美元用于医疗保健,而1971年这一比例为每13美元国民生产总值中有1美元用于医疗保健。如果当前的趋势持续下去,且现有的医疗保健融资安排基本保持不变,预计到1990年全国医疗保健支出将达到约7560亿美元,约占国民生产总值的12%。当今医疗保健领域的核心问题是成本及其上涨。20世纪80年代的前景是持续快速增长,但增速会有所减缓。预计这种增长放缓的主要推动力是通货膨胀率的降低。不过,实际增长率预计也会略有放缓。预计20世纪80年代影响医疗保健支出增长的主要因素将包括人口老龄化、新的医疗技术、竞争加剧、公共资金受限、实际收入增长、医疗人力增加以及整个经济通胀率的下降。与所有行业一样,医疗保健行业的管理人员、政策制定者和供应商在当今的决策中必须考虑到未来可能的趋势。过去十年的通货膨胀、经济冲击以及政策的意外后果,都加剧了对各个行业及其与宏观经济关系进行定期评估的必要性。本文对医疗保健行业进行了这样的评估。对1990年的全国医疗保健支出进行了基于现行法律的基线预测。