Despite a growing role of the federal government in the nation's health care system, individuals are taking on a greater share of the rising costs, according to the new U.S. News Health Care Index

The index was developed as an ongoing way to track health care's changing role in the U.S. economy and society. The first series of data, from 2000 to 2013, presents a comprehensive overview of the U.S. health care system by following movements in health care expenditures, medical costs, insurance coverage, and health care employment, and shows a steady trend upwards.

The largest components – health care expenditures and employment – drive the trend. 

Deductibles – the out-of-pocket costs consumers must pay before their health insurance benefits kick in – are the components that have seen the most growth from 2002 to 2013. 

In 2002 – the earliest year for which data about deductibles were available – less than half of private-sector health insurance plans had a deductible. By 2013, more than 80% had a deductible, and the amount paid by consumers was skyrocketing.

“Premiums were steadily rising,” says Douglas Holtz-Eakin, president of the American Action Forum and former director of the Congressional Budget Office. “Employers tried to manage this expanding price tag by shifting costs to their employees in the form of higher deductibles and increased co-pays. This is one of the factors – in addition to the Great Recession – that contributes to the slowing of health care spending growth in the latter part of the period."

"There is an ongoing narrative about health care's central role in the U.S. economy, but this index demonstrates all of the ways health care is touching every aspect of our society," said Tim Smart, executive editor of U.S. News. "The Health Care Index will allow us to better understand how the health care system is evolving and its broader influence over time."

Key insights from the U.S. News Health Care Index:

  • An expansion of public health insurance: Though data from the Affordable Care Act are not measured in the first version of the index, the federal government's expanded role is already apparent. Government-sponsored health care, including Medicare and Medicaid, have grown at a faster rate than private health insurance. The total percentage of people under the age of 65 with public health insurance coverage increased from 12.9% in 2000 to 23.8% in 2013. Private health insurance coverage decreased from 71.8% to 61% during the same period. 
  • A surge in individual's health care costs: Americans have taken on a higher burden of health care costs, spending 1.7 times more out-of-pocket on health care by 2013. The average cost of deductibles more than doubled over the course of a decade. The percent of premiums paid by employees increased by roughly 4% for both single and family plans, taking up a larger share of individual incomes. Meanwhile, there has been a 55% growth in prescription drug consumer prices. 
  • A dominant role in the U.S. economy: In 2012, the U.S. spent 17.9% of its GDP on health care, more than any other developed nation. Health care's share of the job market has declined since 2011, but health care jobs have steadily increased every year, from 9.7 million in 2000 to 12.5 million in 2013. There continues to be an uptick in undergraduate and graduate health care degrees granted. From 2000 to 2013, associate degrees increased 142%, bachelors grew by 126% and graduate degrees increased by 94%.

The U.S. News Health Care Index features a collection of interactive graphs that show the data, research specific data points and adjust the graphs to illustrate trends. 

It uses information from the U.S. Bureau of Labor Statistics, the Centers for Medicare and Medicaid Services, the United States Centers for Disease Control and Prevention, the Department of Health and Human Services, the National Center for Educational Statistics and the World Health Organization.

“As health care enters an unprecedented change in the way people are covered, how care is paid for and how it’s delivered, we want to better understand how it affects things like jobs and people’s economic well-being,” says Brian Kelly, editor and chief content editor at U.S. News & World Report.


Tags: Obamacare, Affordable Care Act, Health Care, Health care costs, U.S. News Health Care Index, U.S. News & World Report