1. Delaware Health Care Commission March 3, 2005 Alice Burton, Director AcademyHealth

2. 2 Presentation Outline Health care cost trends Impact on access Possible solutions

3. 3 National Health Spending as a share of Gross Domestic Product Source: CMS, National Health Accounts Data

4. 4 Health Care Spending and GDP Trends Source: Center for Studying Health Change, Issue Brief 91, December 2004.

5. 5 Spending by Category of Service Source: Center for Studying Health System Change, Brief 91, December 2004

6. 6 Hospital Spending: Price and Utilization Source: Center for Studying Health System Change, Brief 91, December 2004

7. 7 Long-term Cost Drivers Advances in medical technology Increased resources in medical care Lifestyle changes “Oversold” drivers Population aging Professional liability Mandates Adapted from: Presentation to State Coverage Initiatives National Meeting, February 4, 2005by Paul B. Ginsburg, Ph.D.

8. 8 Delaware Health Statistics Health Spending per capita6th Infant mortality45th Premature Death39th Obesity33rd Physicians per capita16th Hospital beds per capita33rd United Health Foundation32nd Source: CDC, state health profiles, Health United States, United Health Foundation

9. 9 Recent Premium, Cost and Wage Growth Source: KFF/HRET Survey of Employer Health Benefits: 1999-2004

10. 10 Family Health Insurance as percent of wages for different occupations Median Hourly Wage family premium/ median wage Physician$60.10 7.3% History Professor$27.6315.8% LPN$16.1826.9% Secretary$15.0029.1% Bank Teller$ 9.9343.9% Carpenter$18.0024.2% Cook$ 8.7549.8% Source; Nichols, Future of ESI, for CHCF, forthcoming, 2004

11. 11 Low income take-up is falling Source: Nichols and Cunningham, Who are decliners?, Academy Health Annual Research Conference presentation, 2004.

12. 12 Efforts to make insurance more affordable Limited benefits At least 11 states have passed minimum benefit legislation – 4 in 2004 Low enrollment Consumer directed health care Options for state and local employees Legislation to allow qualifying High Deductible Health Plans to be sold in the state Prevention strategies – healthy behaviors