What's behind the health expenditure trends?

Ateev Mehrotra, R. Adams Dudley, Harold S. Luft

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


In this paper, we review the literature on a number of the potential explanations for the rise in health care expenditures in the United States: the aging population, the costs of dying, technology, physician incomes, administrative costs, prescription drags, managed care, and the underfunding of public health. Our goal is not to pass definitive judgment on the force(s) driving health care costs, but rather to make the reader a more educated consumer of these widely cited data. We place special emphasis on how health expenditures are measured and the inherent weaknesses in the methodology. We find that frequently it is difficult to accurately estimate how individual forces influence total health care expenditures. Moreover, we conclude that interpreting the causes of the rise in expenditures goes beyond simple observations of trends and depends on how we value various segments and aspects of health and health care.

Original languageEnglish (US)
Pages (from-to)385-412
Number of pages28
JournalAnnual Review of Public Health
StatePublished - 2003
Externally publishedYes


  • Health care reform
  • National health insurance
  • Public health
  • United States

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