KHN’s ‘What the Health?’: We spend how much on health care?

Health spending in the U.S. grew to $3.6 trillion in 2018, according to a new report from the federal government. The rate of growth — 4.6% — was up slightly from 2017's 4.2%, despite the fact that nearly a million more Americans lacked insurance.

Meanwhile, Congress has less than two weeks to finish a year's worth of work, including the spending bills required to keep the government running and promised legislation to address "surprise" medical bills and prescription drug prices.

This week's panelists are Julie Rovner of Kaiser Health News, Kimberly Leonard of the Washington Examiner, Joanne Kenen of Politico and Mary Agnes Carey of Kaiser Health News.

Among the takeaways from this week's podcast:

• The share of the economy spent on health care actually declined slightly from 2017 to 2018 — from 17.9% to 17.7%. But that will come as small solace to consumers, for whom costs seem to be ever-rising. And it is consumers' concerns driving the political health debate.
• Congress does not appear likely to pass individual spending bills before the current federal spending bill expires Dec. 20. It appears they may have another temporary bill that would likely fund the government until February or March.
• That temporary bill is a tempting target for people advocating for the permanent repeal of the Affordable Care Act's Cadillac tax on generous health plans or a measure to help consumers avoid surprise medical bills when they get unexpected care from a doctor or hospital that is not in their insurer's network of providers.
• Democrats running for president have focused much of their health debate on whether to move toward a "Medicare for All" plan or some other government option, such as allowing people to join Medicare if they lack insurance. But even that scaled-back notion could be extremely disruptive to the employer insurance market. Then again, that's what opponents of the ACA predicted, too, yet the law did not cause employers to drop coverage in large numbers.
• Recent reports have documented a tense relationship between Health and Human Services Secretary Alex Azar and Seema Verma, the head of the Centers for Medicare & Medicaid Services. It's not just personal — the disputes are having a very real impact on the work of the department.
• A Senate committee this week approved the nomination of Stephen Hahn to be the head of the Food and Drug Administration. Although some senators raised questions about the White House's apparent step back from banning flavored vaping products, it appears that Hahn's nomination is likely to be approved by the full Senate.

Also this week, Rovner interviews KHN's Markian Hawryluk, who wrote the latest KHN-NPR "Bill of the Month" installment about the high cost of removing a doll shoe from a toddler's nose. If you have an outrageous medical bill you would like to share with us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: The New York Times' "How a Divided Left Is Losing the Battle on Abortion," by Elizabeth Dias and Lisa Lerer

Joanne Kenen: The BBC's "How a wrong injection helped cause Samoa's measles epidemic"

Kimberly Leonard: The Los Angeles Times' "Their kids died on the psych ward. They were far from alone, a Times investigation found," by Soumya Karlamangla

Mary Agnes Carey: The Washington Post's "How a fight over health care entangled Elizabeth Warren — and reshaped the Democratic presidential race," by Annie Linskey, Jeff Stein and Dan Balz

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