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发帖数: 29846 | 1 As health care reform marks its one-year anniversary, a new Deloitte report
reveals that consumers are spending $363 billion, or 14.7 percent more, on
health care than traditionally reported in official government accounts.
This spending falls outside of conventionally-counted health care costs such
as doctors, prescriptions, hospitals, and health insurance coverage.
Demonstrating the significance of the amount consumers now spend on health
care, the additional costs captured in the new Deloitte study support an
increase in consumer discretionary spending on health care from 16.2 percent
, for items traditionally reported by the government, to 19.9 percent, which
surpasses housing and utility costs at 18.8 percent.
More than half of the spending (55 percent) in these ancillary areas was for
the estimated value of supervisory care, or care given by unpaid relatives
and friends. Supplemental expenditures included complementary and
alternative medicine (CAM) practitioners (8 percent) and products (1 percent
), functional foods and other nutritional products, vitamin and mineral
supplements (15 percent), health publications (1 percent), ambulance
services (3 percent), other ambulatory care, such as blood banks, some
health promotion programs (6 percent), mental health services (8 percent),
homes for the elderly (4 percent), and weight loss facilities (1 percent).
"It has been one year since the passage of health care reform, and our
report sheds new light on the hidden costs of health care and how these
costs can add up significantly to billions of dollars and can even eclipse
housing as a household expense, " said Paul Keckley, Ph.D., executive
director, Deloitte Center for Health Solutions. "Our study explores the
financial context for the decisions consumers – not simply patients – make
about how they spend their money on health care, which will only increase
in importance as health care reform continues to take hold."
The Deloitte report, "The Hidden Costs of U.S. Health Care for Consumers: A
Comprehensive Analysis," was conducted by Deloitte's Center for Health
Solutions and Center for Financial Services to gauge the total costs
consumers really spend out of their own pockets on health care products and
services, beyond what is typically paid by insurers and other government
sources, such as Medicare and Medicaid.
"The ability of the U.S. economy to recover will be affected in part by how
much consumers have in their pockets to spend," said Andrew Freeman,
executive director of the Deloitte Center for Financial Services. "This
reveals a tremendous burden on the average consumer."
Additional findings in the report:
According to the Deloitte study, the total 2009 U.S. per capita
expenditures were $9,217; professional services (29 percent) and hospital
care (27 percent) were the biggest categories.
The estimated value of supervisory care ($199 billion) is significantly
higher than total spending on nursing homes ($144 billion) and total
spending on home health care ($72 billion), and was only somewhat less than
prescription drug expenditures ($246 billion).
Around 70 percent of spending on nutrition industry items was directed
towards functional foods, a category which includes such items as enriched
cereals, breads, sports drinks, bars, fortified snack foods, baby foods, and
prepared meals.
Seniors account for 36 percent ($1.01 trillion) of total health care
expenditures, but are only 13 percent of the population.
Nearly 83 percent of the $2.83 trillion 2009 U.S. health expenditures
were attributed to those with family incomes of $100,000 or less, who make
up 89 percent of the total population.
One in five (21 percent) adults surveyed said they paid a medical bill
late in the last 12 months.
A total of 27 percent of adults estimate that 5 percent or less of their
household budget is spent on health care; 17 percent said 26 percent or
more is spent on health care.
A majority (80 percent) of adults surveyed said they would use generic
medicines, seek free advice from a pharmacist or other medical professional
(70 percent), and use technology (61 percent) if it would save money for
health care.
Approximately 43 percent would visit a retail clinic, and one in five (
20 percent) would visit another country for more affordable medical care.
And, 26 percent would skip a medical test or screening, skip a visit to
the dentist or doctor altogether (26 percent), or skip refilling a
prescription (22 percent) to save money on health care.
"Our study suggests that as the U.S. economy struggles to rebound and
consumers continue to be stretched to pay their bills, they are confronted
with difficult choices, such as paying for health care instead of other
household expenses," added Keckley. "Many consumers are turning to
alternative and over-the-counter products, switching to generic medicines,
or even skipping the doctor or visiting a retail clinic instead to save
money. Health care organizations looking to address these unmet consumer
needs should consider their strategy to expand their focus to include
alternative products and services outside of the confines of the traditional
health care sector."
Methodology
In this study, the most recently available NHEA data (2008) was projected
for 2009. Information drawn from a variety of sources was used to produce
estimates of health expenditure in identified additional areas. Information
from the Medical Expenditure Panel Survey (MEPS) was used to develop
estimates of expenditure by family size and income. When combined, a dataset
was produced which represented a broader picture of the health sector in
2009. This final dataset estimated total health expenditure by payment
source, age group, family income and family size for each health service
area.
Consumer Telephone Survey
The Deloitte Center for Health Solutions commissioned Harris Interactive to
conduct a telephone survey of 1,008 U.S. adults 18 years-old and older
between September 29 – October 4, 2010. Data were weighted to be
representative of the total U.S. adult population on the basis of age, sex,
race/ethnicity, education, region, number of adults in the household, and
the number of phone lines in the household where necessary to align them
with their actual proportions in the population. The survey results have a
sampling error of +/- 3 percentage points at the 95 percent confidence level
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