Health Care Spending: The Story Is Not So Mixed After All

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I made a mistake a couple of days ago, and now all of you have to pay the price by listening to my explanation. Here’s what happened.

My intentions were honorable. The Robert Wood Johnson Foundation put up a chart showing the growth of health care spending over the past two years, but it wasn’t adjusted for inflation. You all know how I feel about that, don’t you? Spending over time should always be adjusted for inflation. So I did the adjustment and posted a revised chart.

But then I got persuaded that I had used the wrong inflation measure. Instead of overall CPI, I should use just the medical component of CPI. So I did that. Unfortunately, I somehow slipped a digit and did it all wrong, which produced a rather odd looking chart. Long story, short, I’ve spent bits and pieces of the past two days trying to decide how to do this right. The answer is: CPI rather than PCE; medical rather than overall inflation; and year-over-year rather than compounded inflation. The original RWJF chart and the newly-corrected inflation-adjusted chart are on the right.

Ironically, what this ends up showing is…nothing. The numbers in the second chart are all lower, but the general trend is the same in both: spending growth peaks at the beginning of 2015 as Obamacare draws more people into the system, and then steadily declines as the flow of new consumers ebbs. The inflation adjustment didn’t change anything.

This is because inflation has been low and pretty flat for the past two years. However, that’s not always guaranteed. Sometimes inflation changes substantially over multi-year periods, and that can make trends in nominal dollars badly misleading. So even though it doesn’t matter much sometimes, always adjust for inflation! The statistical gods will look favorably upon you.

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WE'LL BE BLUNT

It is astonishingly hard keeping a newsroom afloat these days, and we need to raise $253,000 in online donations quickly, by October 7.

The short of it: Last year, we had to cut $1 million from our budget so we could have any chance of breaking even by the time our fiscal year ended in June. And despite a huge rally from so many of you leading up to the deadline, we still came up a bit short on the whole. We can’t let that happen again. We have no wiggle room to begin with, and now we have a hole to dig out of.

Readers also told us to just give it to you straight when we need to ask for your support, and seeing how matter-of-factly explaining our inner workings, our challenges and finances, can bring more of you in has been a real silver lining. So our online membership lead, Brian, lays it all out for you in his personal, insider account (that literally puts his skin in the game!) of how urgent things are right now.

The upshot: Being able to rally $253,000 in donations over these next few weeks is vitally important simply because it is the number that keeps us right on track, helping make sure we don't end up with a bigger gap than can be filled again, helping us avoid any significant (and knowable) cash-flow crunches for now. We used to be more nonchalant about coming up short this time of year, thinking we can make it by the time June rolls around. Not anymore.

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