Copyright ©2014 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

ROBERT SIEGEL, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

AUDIE CORNISH, HOST:

And I'm Audie Cornish. Health care spending grew at a record slow pace for the fourth straight year in 2012. That's according to a government report out today. But the people who compiled it disagree with their bosses in the Obama administration about why the growth of health spending slowed. Obama officials say some credit should go to the Affordable Care Act. But as NPR's Julie Rovner reports, government actuaries aren't so sure.

JULIE ROVNER, BYLINE: First, the good news, at least for those worried about health care inflation, from Micah Hartman of the Centers for Medicare and Medicaid Services' Office of the Actuary.

MICAH HARTMAN: Health care spending increased 3.7 percent in 2012, which was the fourth year of relatively low and stable growth.

ROVNER: In fact, the $2.8 trillion the nation spent on health care consumed 17.2 percent of the nation's economic output, which was actually down slightly from the year before. Why? Well, it was kind of a mixture of things, said actuary Anne Martin.

ANNE MARTIN: Our main findings included faster growth in hospital and physician and clinical services spending, and slower growth in prescription drug and nursing care facility spending.

ROVNER: Martin said one of the big downward drivers of spending was something called the patent cliff or the expiration of patents of some huge blockbuster prescription drugs.

MARTIN: Most notably Lipitor, Plavix, and Singulair lost patent protection in late 2011 and in 2012. This, in turn, led to the availability of lower cost generic versions of these drugs.

ROVNER: And lower spending on drugs overall. But one thing that did not lead to slower growth, according to the report being published today in the policy journal Health Affairs, was the Affordable Care Act. Said Martin...

MARTIN: There was minimal impact from the Affordable Care Act on aggregate national health expenditure trends.

ROVNER: In fact, for the first three years the law was in effect, the actuaries say its various provisions likely combined to produce a small overall increase in spending. And the persistent slow growth in health spending, even for a few years after the economy has begun to recover? Aaron Catlin, deputy director of the National Health Statistics Group that leads the annual study, says that's just what you'd expect to see about now.

AARON CATLIN: What we can tell you is that the period of stability is consistent with the historical experience.

ROVNER: Meaning health inflation has traditionally remained in check for at least a few years following a recession. But the actuaries' view - that health spending is simply following historical trends - is not universal. Many economists think this slowdown may in fact signify a structural change in the way healthcare's being delivered. David Cutler is a Harvard health economist and one of those who thinks this time may be different.

DAVID CUTLER: There's a big unexplained component which is that even though slower economic growth has reduced spending, spending has fallen by even more than the slower economic growth would suggest.

ROVNER: Medicare spending, for example, which by itself accounts for a fifth of the nation's health spending, has slowed dramatically. And Medicare spending is not traditionally tied to what happens in the rest of the economy, says Cutler.

CUTLER: If you look historically, the link between how the economy is doing and what's happening to Medicare spending is very, very weak.

ROVNER: But what is clearly impacting Medicare, he says, are changes made by the Affordable Care Act.

CUTLER: From reduced error rates in hospitals to reduced rates of readmission for Medicare beneficiaries to reduced payments to Medicare advantage plans and hospitals that are a direct result of the Affordable Care Act.

ROVNER: The bottom line is no one really knows exactly why health care spending continues to grow so slowly and how much impact the Affordable Care Act is having on spending. But most policymakers agree on one thing, they hope the spending slowdown will continue. Julie Rovner, NPR News, Washington.

Copyright © 2014 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.