医疗支出会拖垮还是拯救联邦预算？

中文摘要

联邦预算预测在很大程度上取决于医疗支出趋势。自 1970 年以来，医疗支出占国内生产总值（GDP）的份额增长近两倍。然而，2010 年以来支出增长仅略微超过 GDP 增长。增长率上的这一差异使得支出预测变得困难。我通过考察支出增长的来源——从昂贵新疗法的快速增加到成本降低型技术带来的支出减少——推导出未来支出的多种情景。即便支出相对 GDP 仅出现温和增长，也很可能超出联邦政府以现行税收工具为医疗保健买单的能力。

Abstract

Forecasts of the federal budget depend greatly on trends in medical spending. Since 1970, medical spending has nearly tripled as a share of gross domestic product (GDP). However, spending growth has barely exceeded GDP growth since 2010. This difference in growth rates makes forecasting spending difficult. I present scenarios for future spending derived from considering the sources of spending increase, ranging from rapid increases in new, expensive treatments to a reduction in spending due to cost-reducing technology. Even modest increases in spending relative to GDP are likely to overwhelm the federal government’s ability to pay for medical care using current tax instruments.