Health expenditures rising for middle class, wealthy

(HealthDay)—While overall U.S. medical spending growth slowed between 2004 and 2013, expenditures rose for middle- and high-income Americans, according to research published in the July issue of Health Affairs.

Samuel L. Dickman, from Harvard Medical School in Boston, and colleagues assessed trends in health expenditures by people in each quintile of the U.S. population using data from 22 national surveys conducted between 1963 and 2012.

The researchers found that before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures despite their worse health, compared to other income groups. The unadjusted expenditures for the lowest quintile exceeded those for all other income groups by 1977, a pattern that persisted until 2004. After 2004, expenditures fell for the lowest quintile, but rose more than 10 percent for the middle three quintiles and close to 20 percent for the highest income quintile, which had the highest expenditures in 2012. This post-2004 divergence of expenditure trends occurred only among the nonelderly.

"We conclude that the new pattern of spending post-2004, with the wealthiest quintile having the highest expenditures for health care, suggests that a redistribution of care toward wealthier Americans accompanied the health spending slowdown," the authors write.