Abstract

We evaluate the long-run sustainability of health spending growth. Under the criterion that non-health consumption does not fall, 1 percent excess cost growth appears to be an upper bound for the economy as a whole when the projection horizon extends over the century, although some groups would experience declines in non-health consumption. More generally, the increase in health spending as a share of income may lead to a signifi cant expansion of public sector fi nancing, as has been the case historically. Extrapolation of historical trends also suggests that higher health spending will lead to insurance contracts with lower out-of-pocket payment shares, putting further upward pressure on health care expenditures.

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