Abstract
The “state of the art” in forecasting long run medical spending is assessed in models used by CMS, CBO, and the Society of Actuaries. Tracking medical expenditures by nominal dollar growth and real per capita spending are useful, yet focusing on the share (of wages, laborforce, or GDP) provides the perspective most immediately applicable to policy and capable of providing the most robust long run forecasts. Spending limits appear to be a variable result of politics and budgetary constraints more than morbidity and mortality. Although death and taxes may be certainties, “when” and “how much” are not.
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