Projecting long term medical spending growth.

We present a dynamic general equilibrium model of the U.S. economy and the medical sector in which the adoption of new medical treatments is endogenous and the demand for medical services is conditional on the state of technology. We use this model to prepare 75-year medical spending forecasts and a projection of the Medicare actuarial balance, and we compare our results to those obtained from a method that has been used by government actuaries. Our baseline forecast predicts slower health spending growth in the long run and a lower Medicare actuarial deficit relative to the previous projection methodology.

[1]  A. Stergachis,et al.  Group Health Cooperative of Puget Sound , 2002 .

[2]  Elliott S Fisher,et al.  Geography and the debate over Medicare reform. , 2002, Health affairs.

[3]  C. I. Jones,et al.  The Value of Life and the Rise in Health Spending , 2004 .

[4]  What's Different about Health? , 2001 .

[5]  J. Newhouse,et al.  Medical care costs: how much welfare loss? , 1992, The journal of economic perspectives : a journal of the American Economic Association.

[6]  M. Freeland,et al.  Insurance effects on US medical spending (1960-1993). , 1998, Health economics.

[7]  M. Grossman On the Concept of Health Capital and the Demand for Health , 1972, Journal of Political Economy.

[8]  D. Cutler Technology, Health Costs, and the NIH , 1995 .

[9]  J. Newhouse,et al.  Has the erosion of the medical marketplace ended? , 1988, Journal of health politics, policy and law.

[10]  Thomas F. Rutherford,et al.  Applied General Equilibrium Modeling with MPSGE as a GAMS Subsystem: An Overview of the Modeling Framework and Syntax , 1999 .

[11]  Charles L. Ballard,et al.  Financing Universal Health Care in the United States: A General Equilibrium Analysis of Efficiency and Distributional Effects , 1999, National Tax Journal.

[12]  Bengt Jönsson,et al.  International comparisons of health expenditure: Theory, data and econometric analysis , 2000 .

[13]  D. Cutler,et al.  Increased spending on health care: how much can the United States afford? , 2003, Health affairs.

[14]  J. Mitchell,et al.  Physician-induced demand for surgery. , 1986, Journal of health economics.

[15]  Jack E. Triplett,et al.  What's Different about Health? Human Repair and Car Repair in National Accounts and in National Health Accounts , 2001 .

[16]  Burton A. Weisbrod,et al.  The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment , 1991 .

[17]  M. Warshawsky An Enhanced Macroeconomic Approach to Long-Range Projections of Health Care and Social Security Expenditures as a Share of GDP , 1999 .

[18]  D. Meltzer Can Medical Cost-Effectiveness Analysis Identify the Value of Research? , 2003 .

[19]  R. Milne,et al.  On the effect of income and relative price on demand for health care: EC evidence , 1991 .

[20]  David O. Meltzer Theoretical Foundations of Medical Cost-Effectiveness Analysis , 2001 .

[21]  L. Sheiner,et al.  The Sustainability of Health Spending Growth , 2005, National Tax Journal.

[22]  Ben Vollaard,et al.  The Elasticity of Demand for Health Care: A Review of the Literature and Its Application to the Military Health System , 2002 .

[23]  E. Keeler,et al.  Health insurance and the demand for medical care: evidence from a randomized experiment. , 1987, The American economic review.

[24]  Michael Grossman,et al.  The Human Capital Model , 2000 .

[25]  Distributional Effects Financing Universal Health Care in the United States: A General Equilibrium Analysis of Efficiency and , 1999 .

[26]  T. Getzen,et al.  Forecasting Health Expenditures: Short, Medium and Long (Long) Term , 2000, Journal of health care finance.

[27]  W. Nordhaus,et al.  The Health of Nations: The Contribution of Improved Health to Living Standards , 2002 .

[28]  D. Remler,et al.  What Every Public Finance Economist Needs to Know About Health Economics: Recent Advances and Unresolved Questions , 2002, National Tax Journal.

[29]  C. I. Jones,et al.  Why Have Health Expenditures as a Share of GDP Risen so Much? , 2002 .

[30]  D. Parkin International comparisons of health expenditure. , 1993, Journal of public health medicine.

[31]  Z. Griliches,et al.  Medical Care Prices and Output , 2000 .

[32]  T. Getzen,et al.  Health Care is an Individual Necessity and a National Luxury: Applying Multilevel Decision Models to the Analysis of Health Care Expenditures , 2000, Journal of health economics.

[33]  David A. Wise,et al.  Inquiries in the economics of aging , 1998 .

[34]  J. Newhouse Free for All?: Lessons from the RAND Health Insurance Experiment , 1993 .

[35]  M. Mcclellan,et al.  Is technological change in medicine worth it? , 2001, Health affairs.

[36]  A. Sisko,et al.  Health spending projections through 2015: changes on the horizon. , 2006, Health affairs.

[37]  D. Meltzer Theoretical Foundations of Medical Cost-Effectiveness Analysis -- Implications for the Measurement of Benefits and Costs of Medical Interventions , 2001 .

[38]  Thomas F. Rutherford,et al.  Approximating infinite-horizon models in a complementarity format: A primer in dynamic general equilibrium analysis , 2002 .

[39]  U. Gerdtham,et al.  Price and quantity in international comparisons of health care expenditure , 1991 .

[40]  D. Blumenthal,et al.  Is the Target Income Hypothesis an Economic Heresy? , 1996, Medical care research and review : MCRR.

[41]  H. Lazenby,et al.  Age Estimates in the National Health Accounts , 2004, Health care financing review.

[42]  S. Sonnad,et al.  Managed Care, Medical Technology, and Health Care Cost Growth: A Review of the Evidence , 1998, Medical care research and review : MCRR.

[43]  V. Fuchs,et al.  Economics, values, and health care reform. , 1996, The American economic review.