Health Care Cost Containment: No Longer an Option but a Mandate

The growth in health care costs in the United States in the past two decades has been staggering and extraordinarily burdensome not only to the federal and state governments but also to employers and individuals who purchase their health insurance in the private market. In 2009, national health expenditures (“NHE”) in the United States grew by 4% to $2.5 trillion, or $8,086 per capita, and accounted for 17.6% of gross domestic product (“GDP”). According to the Office of the Actuary at the Centers for Medicare and Medicaid Services (“CMS”), growth in NHE is expected to increase an average of 5.7% per year over the period of 2011–2021, and to account for 19.6% of overall spending by 2021 and almost 50% of overall spending by 2082. These predictions are troubling not only because the United States already spends more than one-sixth of GDP on health care but perhaps, more importantly, because growth in health care costs substantially outstrips both GDP growth and real earnings. This excess growth of health care costs over economic growth levies unsustainable burdens on all health care payers includ-