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  • 8/14/2019 Health Care Trends: Analysis of Real Changes in U.S. Health Care and Health Insurance Costs from 1998 to 2008, Zpryme

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    Abstract:The purpose of this report is to assess real changes in the costs of healthcare and health insurance in the U.S. and in 18 major metropolitanareas in the U.S. from 1998 to 2008. Additionally, this report identifiesage groups that have experienced the largest increases in their healthcare costs and health insurance costs during this time period.

    Published: January2010FOR MORE INFORMATIONwww.zpryme.com

    Health Care TrendsAnalysis of RealChanges in U.S. Health Care and Health Insurance Costs from 1998 to 2008

    http://www.zpryme.com/http://www.zpryme.com/
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    About ZprymeZpryme is a research-basedadvisory firm with servicesperformed in two vital areas -business and consumer insights.

    Zpryme is your go-to fordelivering relevant, actionable

    insight and consultationspecific to your individualneeds. At Zpryme, we helporganizations solve immediatebusiness problems and achievelong-term success.

    Providing: Advisory Branding Solutions Buzz Research Market Research

    Learn More @www.zpryme.com | +1 (888) ZPRYME.1 | [email protected]

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    Table of ContentsSummary of Key Findings ................................................................................................................................................................................................. .............................. 2

    U.S. Health Care Costs .................................................................................................................................................................................................................................... 5U.S. Health Care Costs by Age ..................................................................................................................................................................................................................... 6U.S. Health Insurance Costs by Age.............................................................................................................................................................................................................. 7Health Insurance as a Percent of Total Health Care Costs....................................................................................................................................................................... 8U.S. Changes in Income, Health Care, and Health Insurance Costs ........................................................................................................................................................ 9U.S. Health Care Costs as a Percent of Income............................................................................................................................................................ ............................ 10Western Metro Areas.................................................................................................................................................. .................................................................................. 11Northeastern Metro Areas........................................................................................................................................................................ .................................................... 12Southern Metro Areas ................................................................................................................................................. .................................................................................. 13Midwestern Metro Areas .......................................................................................................................................................................... .................................................... 14U.S. Metro Area Income Changes ........................................................................................................................................................... .................................................... 15U.S. Metro Area Health Care Cost Changes ................................................................................................................................................................ ............................ 16Differences Between Health Care Cost and Income Changes ............................................................................................................................................................... 17Health Care Costs as a Percent of Income by Metro Area .................................................................................................................................................................... 18U.S. Metro Area Health Care Costs........................................................................................................................................................ .................................................... 19

    DisclaimerThese materials and the information contained herein are provided by Zpryme Research & Consulting, LLC and are intended to pr ovide general information on a particular subject or subjects and is not an exhaustive treatmentof such subject(s). Accordingly, the information in these materials is not intended to constitute accounting, tax, legal, investment, consulting or other professional advice or services. The information is not intended to be relied uponas the sole basis for any decision which may affect you or your business. Before making any decision or taking any action tha t might affect your personal finances or business, you should consult a qualified professional adviser.These materials and the information contained herein is provided as is, and Zpryme Research & Consulting, LLC makes no express or implied representations or warranties regarding these materials and the information herein.Without limiting the foregoing, Zpryme Research & Consulting, LLC does not warrant that the materials or information contained herein will be error-free or will meet any particular criteria of performance or quality. ZprymeResearch & Consulting, LLC expressly disclaims all implied warranties, including, without limitation, warranties of merchantability, title, fitness for a particular purpose, noninfringement, compatibility, security, and accuracy.Prediction of future events is inherently subject to both known and unknown risks, uncertainties and other factors that may cause actual results to vary materially. Your use of these and the information contained herein is at your

    own risk and you assume full responsibility and risk of loss resulting from the use thereof. Zpryme Research & Consulting, LLC will not be liable for any special, indirect, incidental, consequential, or punitive damages or any otherdamages whatsoever, whether in an action of contract, statute, tort (including, without limitation, negligence), or otherwise, relating to the use of these materials and the information contained herein.

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    Health Care Insight

    Clearly, getting spiraling health insurance costs under control is the key to

    stabilizing health care costs for all Americans.

    Some Americans have seen their incomes grow just as fast as or faster than their

    health care costs. Thus the financial adversity caused by increasing health care

    costs is not equally shared among all Americans.

    Americans now have to make more incremental economic choices such as payingtheir insurance co- payment to see a doctor or to purchase a days worth ofgroceries for their family. In fact, Americans age 65 and above are most likely toface such economic choices as their health care costs as a percent of their income

    are almostthree times higher than other Americans.

    Jason S. Rodriguez, Zpryme CEO & Director of Research

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    Purpose

    The purpose of this report is to assess real changes in the costs of health care and health insurance in the U.S. and in 18 major metropolitan areas inthe U.S. from 1998 to 2008. Additionally, this report analyzes the change in average annual income for U.S. consumers. Last, this report identifies agegroups that have experienced the largest increases in their health care costs and health insurance costs from 1998 to 2008.

    Inflation Adjustment and Data Sources

    In this analysis Zpryme standardized U.S. historical annual average income, health care costs, and health insurance costs from 1998 to 2008 using theConsumer Price Index (CPI) for urban consumers. In this analysis all values are converted to 2008 constant dollars. Due to inflation, the purchasingpower of the dollar changes over time, so in order to compare dollar values from one year to another they need to be converted to constant dollarvalues. By adjusting for inflation, we can uncover the real growth in annual average health care costs and health insurance costs from 1998 to 2008.Data for this analysis was obtained from the U.S Bureau of Labor Statistics Consumer Expenditure Surveyand Consumer Price Index.

    Summary of Key Findings

    In 2008, health insurance costs accounted for 56.0% of total health care costs versus 48.0% of total health care costs in 1998. From 1998 to 2008, inflation adjusted health care costs for consumers age 55-64, 65-74, and 75 and up increased by $975, $905, and

    $532, respectively.

    From 1998 to 2008, inflation adjusted health insurance costs for consumers age 65-74 and 75 and up increased by $855 and $798,respectively.

    From 1998 to 2008, health insurance costs as a percent of total health care costs increased across all age groups in this analysis. From 1998 to 2008, among all U.S. consumers, inflation adjusted income, health care, and health insurance costs increased by 16.0%, 18.0%,

    and 37.0%, respectively. Health care and health insurance costs increased the most among 55-64 year-olds.

    In 2008, health care costs as a percent of total income were highest among consumers age 65 and up. From 1998 to 2008, Cleveland, Seattle, San Francisco, Boston, Phoenix, and Minneapolis-St. Paul experienced the greatest increase in their

    health care costs relative to their increase in income.

    After adjusting for inflation, 16 out of the 18 U.S. metro areas in this analysis experienced an increase in their health care costs from 1998 to2008.

    All 18 U.S. metro areas in this analysis experienced an increase in their average annual income from 1998 to 2008. From 1998 to 2008, health care costs as a percent of total income increased for 10 of the metro areas in this analysis and decreased for 8 of

    the metro areas in this analysis.

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    U.S. Health Care CostsFrom 1998 to 2008, U.S. inflation adjusted health care costs increased from $2,514 to $2,976. During this time period, inflation adjusted healthinsurance costs increased from $1,206 to $1,653. In 2008, health insurance costs accounted for 56.0% of total health care costs versus 48.0% of totalhealth care costs in 1998.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    $2,514 $2,532$2,583

    $2,653

    $2,813 $2,828

    $2,934 $2,937 $2,954$2,963 $2,976

    $1,206 $1,193 $1,229$1,290

    $1,398$1,465

    $1,518 $1,500$1,565 $1,604

    $1,653

    $0

    $500

    $1,000

    $1,500

    $2,000

    $2,500

    $3,000

    $3,500

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average U.S. Health Care and Health Insurance Costs, 1998

    2008(inflation adjusted to 2008 constant dollars)

    Health care Health insurance

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    U.S. Health Care Costs by AgeAs expected, higher inflation adjusted health care costs are strongly related to the age of consumers. From 1998 to 2008, inflation adjusted healthcare costs for consumers age 55-64, 65-74, and 75 and up increased by $975, $905, and $532, respectively. Consumers under 25 and 25-54experienced the smallest increases in their health care costs when compared to the other age groups in this analysis.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    $588$712

    $630 $644$766

    $639$745 $776 $754

    $831

    $682

    $1,565 $1,512 $1,570 $1,563$1,696 $1,718 $1,731 $1,678

    $1,764 $1,807 $1,737

    $2,230$2,108

    $2,218$2,284

    $2,370$2,464

    $2,579$2,505 $2,439 $2,404

    $2,499

    $2,887

    $2,821$2,751 $2,754

    $3,052$2,901

    $3,072$2,946 $2,944 $2,899 $2,930

    $2,850

    $3,166 $3,136$3,286

    $3,599 $3,580

    $3,718 $3,759$3,798

    $3,609

    $3,825$3,874 $3,865

    $3,955

    $4,356 $4,295$4,244

    $4,330

    $4,604

    $4,677

    $5,158

    $4,779

    $3,881 $3,944$4,173 $4,130 $4,290

    $4,513 $4,553

    $4,641$4,573

    $4,439 $4,413

    $0

    $500

    $1,000

    $1,500

    $2,000

    $2,500

    $3,000

    $3,500

    $4,000

    $4,500

    $5,000

    $5,500

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average U.S. Health Care Costs, 1998

    2008by Age Group | (inflation adjusted to 2008 constant dollars)

    Under 25 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and up

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    U.S. Health Insurance Costs by AgeFrom 1998 to 2008, inflation adjusted health insurance costs for consumers age 65-74 and 75 and up increased by $855 and $798, respectively.Consumers age 25-54 experienced the smallest increases in their health insurance costs when compared to the other age groups in this analysis.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998

    2008)

    $272 $301 $264 $305$341 $329 $366

    $416 $392$412

    $389

    $798 $772 $800

    $845$912 $948

    $960$906 $943

    $953 $983$1,043

    $964$1,063

    $1,125$1,224

    $1,298$1,367

    $1,279 $1,296 $1,318$1,341

    $1,243 $1,217 $1,220$1,262

    $1,412 $1,365$1,471

    $1,414 $1,399 $1,439$1,523

    $1,309 $1,374$1,415 $1,445

    $1,623

    $1,840$1,786 $1,747

    $1,790 $1,818

    $1,945

    $2,046 $2,032$2,010

    $2,138

    $2,299 $2,310

    $2,474

    $2,593

    $2,903 $2,929 $2,901

    $1,985 $1,982

    $2,039$2,179 $2,213

    $2,377 $2,411$2,491

    $2,682

    $2,820 $2,783

    $0

    $500

    $1,000

    $1,500

    $2,000

    $2,500

    $3,000

    $3,500

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average U.S. Health Insurance Costs, 1998 2008by Age Group | (inflation adjusted to 2008 constant dollars)

    Under 25 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and up

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    Health Insurance as a Percent of Total Health Care CostsAcross all age groups, from 1998 to 2008, health insurance costs accounted for a larger amount of total health care costs. As expected, healthinsurance costs as a percent of total health care costs were the greatest for consumers age 65 and up. Interestingly, consumers age 55-64 paid theleast amount of health insurance costs as a percent of their total health care costs in 2008.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    46% 42% 42% 47% 45% 51% 49%54% 52% 50% 57%

    51% 51% 51%54% 54%

    55% 55% 54% 53% 53%57%

    47% 46% 48%49% 52%

    53% 53% 51% 53% 55%54%

    43% 43% 44%46% 46%

    47% 48% 48% 48% 50%52%

    46%43% 45%

    44% 45%51% 48% 46% 47% 50%

    51%

    53%53% 51%

    49% 54%

    54% 57% 56% 62% 57%61%

    51%50%

    49%53% 52%

    53%53% 54%

    59% 64%63%

    0%

    50%

    100%

    150%

    200%

    250%

    300%

    350%

    400%

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    U.S. Health Insurance Costs as a Percent of Total Health Care Costs, 1998

    2008by Age Group | (inflation adjusted to 2008 constant dollars)

    75 and up

    65 to 74

    55 to 64

    45 to 54

    35 to 44

    25 to 34

    Under 25

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    U.S. Changes in Income, Health Care, and Health Insurance CostsFrom 1998 to 2008, among all U.S. consumers, inflation adjusted income, health care, and health insurance costs increased by 16.0%, 18.0%, and37.0%, respectively. Health care and health insurance costs increased the most among 55-64 year-olds. Consumers under 25, 65-74, and 75 and upalso experienced a significant increase in health insurance costs.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    16%

    26%

    8%

    15%

    6%

    23%

    27%

    23%

    18%

    16%

    11% 12%

    1%

    34%

    23%

    14%

    37%

    43%

    23%

    29%

    23%

    49%

    42%40%

    0%

    10%

    20%

    30%

    40%

    50%

    60%

    All U.S. Consumers Under 25 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and up

    Percent Change in Annual Average Income, Health Care Costs, and Health Insurance Costs,1998 - 2008by Age Group| (inflation adjusted to 2008 constant dollars)

    Income Before Taxes Health Care Health Insurance

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    U.S. Health Care Costs as a Percent of IncomeAmong all U.S. consumers, health care costs as a percent of total income increased from 2.2% to 2.6% from 1998 to 2008. In 2008, health care costsas a percent of total income were highest among consumers age 65 and up.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    2.2%

    1.2%

    1.4%

    1.6%

    1.6%

    2.2%

    5.7%

    7.4%

    2.6%

    1.4%

    1.6%

    1.7%

    1.9%

    2.7%

    6.4%

    8.5%

    0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 8.0% 9.0%

    All U.S.Consumers

    Under 25

    25 to 34

    35 to 44

    45 to 54

    55 to 64

    65 to 74

    75 and up

    Health Care Costs as a Percent of Income,1998 - 2008by Age Group| (inflation adjusted to 2008 constant dollars)

    2008

    1998

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    Western Metro AreasAmong the 5 Western metro areas in this analysis, Seattle had the highest health care costs in 2008 ($3,373) while San Diego had the lowest($1,840). From 1998 to 2008, inflation adjusted health care costs in Los Angeles, San Francisco, Seattle, and Phoenix increased by 19.6%, 41.2%,55.3%, and 39.3%, respectively. During this time period, health care costs in San Diego decreased by 22.2%.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (19982008)

    $0

    $250

    $500

    $750

    $1,000

    $1,250

    $1,500

    $1,750

    $2,000

    $2,250

    $2,500

    $2,750

    $3,000

    $3,250

    $3,500

    $3,750

    $4,000

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average Health Care Costs, 1998

    2008Los Angeles, San Francisco, San Diego, Seattle, and Phoenix Metro Areas

    (inflation adjusted to 2008 constant dollars)

    Los Angeles San Francisco San Diego Seattle Phoenix

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    Northeastern Metro AreasAmong the 5 Northeastern metro areas in this analysis, Washington, D.C. had the highest health care costs in 2008 ($2,996) while Baltimore had thelowest ($2,571). From 1998 to 2008, inflation adjusted health care costs in Washington, D.C., Baltimore, New York, Philadelphia, and Bostonincreased by 1.3%, 21.7%, 14.4%, 20.7%, and 31.3%, respectively.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    $0

    $250

    $500

    $750

    $1,000

    $1,250

    $1,500

    $1,750

    $2,000

    $2,250

    $2,500

    $2,750

    $3,000

    $3,250

    $3,500

    $3,750

    $4,000

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average Health Care Costs, 1998

    2008Washington, D.C., Baltimore, New York, Philidelphia, and Boston Metro Areas

    (inflation adjusted to 2008 constant dollars)

    Washington, D.C. Baltimore New York Philadelphia Boston

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    Southern Metro AreasAmong the 4 Southern metro areas in this analysis, Houston had the highest health care costs in 2008 ($3,002) while Miami had the lowest ($1,933).From 1998 to 2008, inflation adjusted health care costs in Miami, Dallas-Fort Worth, and Houston increased by 3.2%, 0.4%, and 17.5%, respectively.During this time period, health care costs in Atlanta decreased by 3.6%.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    $0

    $250

    $500

    $750

    $1,000

    $1,250

    $1,500

    $1,750

    $2,000

    $2,250

    $2,500

    $2,750

    $3,000

    $3,250

    $3,500

    $3,750

    $4,000

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average Health Care Costs, 1998

    2008Atlanta, Miami, Dallas-Ft Worth, and Houston Metro Areas

    (inflation adjusted to 2008 constant dollars)

    Atlanta Miami Dallas- Fort Worth Houston

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    Midwestern Metro AreasAmong the 4 Midwestern metro areas in this analysis, Minneapolis-St. Paul had the highest health care costs in 2008 ($3,365) while Detroit had thelowest ($2,432). From 1998 to 2008, inflation adjusted health care costs in Chicago, Detroit, Minneapolis-St. Paul, and Cleveland increased by27.1%, 14.8%, 16.6%, and 82.1%, respectively.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    $0

    $250

    $500

    $750

    $1,000

    $1,250

    $1,500

    $1,750

    $2,000

    $2,250

    $2,500

    $2,750

    $3,000

    $3,250

    $3,500

    $3,750

    $4,000

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    Annual Average Health Care Costs, 1998

    2008Chicago, Detroit, Minneapolis-St.Paul, and Cleveland Metro Areas

    (inflation adjusted to 2008 constant dollars)

    Chicago Detroit Minneapolis-St.Paul Cleveland

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    U.S. Metro Area Income ChangesAfter adjusting for inflation, all 18 U.S. metro areas in this analysis experienced an increase in their average annual income before taxes from 1998to 2008. During this time period, Chicago, Baltimore, Washington, D.C., and Houston experienced the greatest increase in income. Minneapolis-St.Paul, Miami, Dallas-Fort Worth, and Detroit incomes increased the least among the 18 metro areas.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    1.0%

    1.6%

    2.7%

    3.7%

    10.4%

    11.7%

    12.0%

    12.8%

    13.0%

    13.5%

    16.1%

    21.7%

    22.2%

    22.4%

    25.5%

    27.5%

    35.6%

    35.7%

    0% 5% 10% 15% 20% 25% 30% 35% 40%

    Minneapolis-St.Paul

    Miami

    Dallas- Fort Worth

    Detroit

    Atlanta

    Philadelphia

    San Diego

    Los Angeles

    Cleveland

    Boston

    Seattle

    Phoenix

    San Francisco

    New York

    Houston

    Washington, D.C.

    Baltimore

    Chicago

    Percent Change in Annual Average Income, 1998 - 2008by U.S. Metro Area | (inflation adjusted to 2008 constant dollars)

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    U.S. Metro Area Health Care Cost ChangesAfter adjusting for inflation, 16 out of the 18 U.S. metro areas in this analysis experienced an increase in their health care costs from 1998 to 2008.During this time period, Cleveland, Seattle, San Francisco, Phoenix, and Boston experienced the greatest increase in their health care costs. OnlyAtlanta and San Diego experienced a decrease in their health care costs during this time period.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    -22.2%

    -3.6%

    0.4%

    1.3%

    3.2%

    14.4%

    14.8%

    16.6%

    17.5%

    19.6%

    20.7%

    21.7%

    27.4%

    31.3%

    39.3%

    41.2%

    55.3%

    82.1%

    -40% -20% 0% 20% 40% 60% 80% 100%

    San Diego

    Atlanta

    Dallas- Fort Worth

    Washington, D.C.

    Miami

    New York

    Detroit

    Minneapolis-St.Paul

    Houston

    Los Angeles

    Philadelphia

    Baltimore

    Chicago

    Boston

    Phoenix

    San Francisco

    Seattle

    Cleveland

    Percent Change in Annual Average Health Care Costs, 1998 - 2008by U.S. Metro Area | (inflation adjusted to 2008 constant dollars)

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    Differences Between Health Care Cost and Income ChangesFrom 1998 to 2008, Cleveland, Seattle, San Francisco, Boston, Phoenix, and Minneapolis-St. Paul experienced the greatest increase in their healthcare costs relative to their increase in income. On the other hand, San Diego, Washington, D.C., Atlanta, and Baltimore experienced the greatestincrease in their incomes relative to their increase in health care costs.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

    -34.3

    -26.2

    -14.0

    -14.0

    -8.3

    -8.1

    -8.0

    -2.3

    1.6

    6.8

    9.0

    11.1

    15.7

    17.6

    17.8

    19.0

    39.2

    69.1

    -40.0 -20.0 0.0 20.0 40.0 60.0 80.0

    San Diego

    Washington, D.C.

    Atlanta

    Baltimore

    Chicago

    New York

    Houston

    Dallas- Fort Worth

    Miami

    Los Angeles

    Philadelphia

    Detroit

    Minneapolis-St.Paul

    Phoenix

    Boston

    San Francisco

    Seattle

    Cleveland

    Net Percentage Point Difference Between Change in Health Care Costs and Change in Income, 1998 - 2008by Metro Area | (infaltion adjusted to 2008 costant dollars)

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    Health Care Costs as a Percent of Income by Metro AreaFrom 1998 to 2008, health care costs as a percent of total income increased in 10 out of the 18 metro areas in this analysis. In 2008, health care costsas a percent of income were highest for consumers in Cleveland and Minneapolis-St. Paul and lowest for consumers in San Diego and Washington, D.C.

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998

    2008)

    3.8%

    3.6%

    3.5%

    3.2%

    3.2%

    3.9%

    3.7%

    3.4%

    3.2%

    3.4%

    4.2%

    3.7%

    4.4%

    4.6%

    3.9%

    3.4%

    4.1%

    3.6%

    2.7%

    2.9%

    3.1%

    3.3%

    3.4%

    3.4%

    3.4%

    3.6%

    3.7%

    3.9%

    4.0%

    4.1%

    4.3%

    4.3%

    4.5%

    4.5%

    4.7%

    5.8%

    0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0%

    San Diego

    Washington, D.C.

    Baltimore

    Miami

    Los Angeles

    Atlanta

    New York

    Philadelphia

    San Francisco

    Boston

    Houston

    Detroit

    Dallas- Fort Worth

    Chicago

    Phoenix

    Seattle

    Minneapolis-St.Paul

    Cleveland

    Health Care Costs as a Percent of Income,1998 - 2008

    by Metro Area| (inflation adjusted to 2008 constant dollars)

    2008

    1998

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    U.S. Metro Area Health Care CostsTable 1. below shows that Cleveland and Seattle have experienced the largest net increases in their health care costs from 1998 to 2008. During thistime period annual average health care costs in Cleveland increased from $2,005 to $3,651 and from $2,171 to $3,373 in Seattle. In 2008, Miamiand San Diego paid the least in health care costs among the 18 metro areas in this analysis.

    Table 1. Annual Average Health Care Costs, 1998 2008 by Metro Area(inflation adjusted to 2008 constant dollars)

    Metro Area 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008Net Change1998 - 2008

    % Change1998 - 2008

    Los Angeles $2,100 $2,271 $2,292 $2,316 $2,431 $2,570 $2,632 $2,508 $2,473 $2,413 $2,512 $412 19.6%

    San Francisco $2,352 $2,316 $2,538 $2,638 $2,812 $3,020 $3,163 $3,057 $3,012 $3,348 $3,321 $969 41.2%

    San Diego $2,366 $2,391 $2,409 $2,153 $2,255 $2,663 $2,969 $3,349 $3,653 $2,713 $1,840 -$526 -22.2%

    Seattle $2,171 $2,495 $3,143 $3,014 $2,784 $3,195 $3,410 $3,208 $3,085 $3,247 $3,373 $1,202 55.3%

    Phoenix $2,293 $2,594 $2,711 $2,493 $2,682 $2,986 $2,974 $3,186 $3,347 $3,175 $3,195 $902 39.3%Washington, D.C. $2,959 $2,846 $2,778 $2,778 $2,634 $2,679 $2,757 $2,767 $2,675 $2,742 $2,996 $37 1.3%

    Baltimore $2,113 $2,043 $2,304 $2,292 $2,202 $2,467 $2,367 $2,442 $2,724 $2,524 $2,571 $458 21.7%

    New York $2,474 $2,408 $2,451 $2,587 $2,725 $2,616 $2,535 $2,659 $2,784 $2,777 $2,829 $355 14.4%

    Philadelphia $2,222 $2,302 $2,224 $2,338 $2,475 $2,502 $2,423 $2,485 $2,337 $2,259 $2,682 $460 20.7%

    Boston $2,236 $2,179 $2,176 $2,411 $2,461 $2,349 $2,592 $2,893 $2,984 $2,917 $2,936 $700 31.3%

    Atlanta $2,473 $2,371 $2,388 $2,362 $2,406 $2,227 $2,006 $2,025 $2,154 $2,445 $2,383 -$90 -3.6%

    Miami $1,873 $1,914 $2,183 $2,292 $2,357 $2,410 $2,193 $2,208 $2,339 $2,250 $1,933 $60 3.2%

    Dallas- Fort Worth $2,776 $2,776 $2,454 $2,507 $2,911 $3,316 $3,491 $3,337 $3,284 $3,081 $2,787 $11 0.4%

    Houston $2,556 $2,480 $2,744 $2,985 $2,931 $2,919 $3,011 $3,243 $3,480 $3,419 $3,002 $446 17.5%

    Chicago $2,610 $2,521 $2,542 $2,597 $2,699 $2,881 $3,082 $3,233 $3,074 $3,136 $3,324 $714 27.4%

    Detroit $2,119 $2,198 $2,048 $2,328 $2,579 $2,340 $2,285 $2,493 $2,509 $2,396 $2,432 $313 14.8%Minneapolis -St.Paul $2,885 $2,923 $2,918 $2,740 $2,749 $3,015 $3,337 $3,417 $3,548 $3,847 $3,365 $480 16.6%

    Cleveland $2,005 $2,147 $2,213 $2,140 $2,309 $2,382 $2,463 $2,866 $3,241 $3,419 $3,651 $1,646 82.1%

    Data: U.S Bureau of Labor Statistics: Consumer Expenditure Survey and Consumer Price Index (1998 2008)

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