Comparing Medicare and Private Cost Growth: Lessons from the Past, Guidance for the Future

Numerous comparisons have been made between the rates of spending growth in Medicare and private health insurance. Many believe that private sector innovations present opportunities for constraining Medicare costs. Nonetheless, recent research looking at the past 30 years concludes that Medicare spending growth has been similar to the private sector, and at times even slower. Figures from the Centers for Medicare and Medicaid Services show Medicare cost growth was lower than that of private insurance in 2000 and 2001. Some of the difference may be attributed to the fact that private insurance, unlike Medicare, usually covers outpatient prescription drugs, one of the fastest-growing segments of health care. Moreover, some analysts say that Medicare’s relative success in controlling costs has been at the expense of quality and access.

Employer Coverage: Mounting Challenges, New Approaches

Employers enjoyed relatively low health care cost increases in the mid-1990s, but the situation since then has drastically changed. Employer-paid health care premiums in 2002 rose an average of 12.7 percent, the highest leap since 1990, according to a recent major survey. Benefits consultants project even higher increases for 2003. Meanwhile, small businesses have faced even steeper increases than larger firms. Many have responded by discontinuing health coverage for their workers. Sixty-one percent of small firms offered benefits in 2002, down from 67 percent in 2000.