The Peterson-Kaiser Health System Tracker provides an easy-to-understand dashboard of key indicators of how the U.S. health system is performing on quality, cost and spending. The interactive dashboard allows users to look behind the headlines. For example, the data show that while overall health spending increased from less than 7 percent of the Gross Domestic Product in 1970 to nearly 18 percent today, the rate of growth in the three largest categories – prescription drugs, hospitals and physicians and clinics has slowed significantly in the first half of the current decade. In the 1970s, for example, spending on hospital care rose 14 percent, physician/clinic costs increased 12.8 percent and prescription drug prices were up 8.1 percent. Between 2010 and 2015, cost increases were more modest: up 5.1 percent for prescription drugs, 4.7 percent for hospitals and 4.4 percent for physicians and clinics.

With drug prices going up faster than other health spending, it’s not surprising that the pharmaceutical industry is spending millions to “squelch talk about high drug prices,” as Kaiser Health News reports in a Dec. 19, 2017, Washington Post Health and Science blog. “Facing bipartisan hostility over high drug prices in an election year, the pharma industry’s biggest trade group boosted revenue by nearly a fourth last year and spread the millions collected among hundreds of lobbyists, politicians and patient groups, new filings show. It was the biggest surge for the Pharmaceutical Research and Manufacturers of America, known as PhRMA, since the group took battle stations to advance its interests in 2009 during the run-up to the Affordable Care Act,” said the news report.

Bankruptcy filings in the United States are down, with the decline correlated to implementation of the Affordable Care Act, according to Consumer Reports in a May 2017 story. “Filings have dropped about 50 percent, from 1,536,799 in 2010 to 770,846 in 2016.Those years also represent the time frame when the ACA took effect. Although courts never ask people to declare why they’re filing, many bankruptcy and legal experts agree that medical bills had been a leading cause of personal bankruptcy before public healthcare coverage expanded under the ACA. Unlike other causes of debt, medical bills are often unexpected, involuntary, and large.

A June 2017 article in The Atlantic offers a different perspective, noting that higher out-of-pocket costs – including the rapid run-up in many pharmaceutical prices – are affecting even those who have health insurance. “The current debate over the future of the Affordable Care Act is obscuring a more pedestrian reality. Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders faced a deductible, the amount people need to pay on their own before their insurance kicks in, of at least $1,000. For people who buy their insurance via one of the Affordable Care Act’s exchangesthat figure will be higher still: Almost 90 percent have deductibles of $1,300 for an individual or $2,600 for a family.”