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Tribbulations.(health spending)

National Review

| December 17, 2007 | Hassett, Kevin A. | COPYRIGHT 2007 National Review, Inc. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

FOR my money, the best of all the original Star Trek episodes was "The Trouble with Tribbles." In that epic show, Lieutenant Uhura brings a delightful little ball of fur called a "tribble" back to the USS Enterprise. The tribbles purr and cuddle, and the crew of the Enterprise fall in love. There is only one problem. The creatures, as Dr. McCoy notices halfway through the show, are "born pregnant." If you let something double repeatedly, then the numbers get large very quickly. Near the end of the show, the Enterprise is stuffed with millions of tribbles.

If you want to understand the economics of health spending, then you need to think tribbles. Spending on health care takes up about double the share of GDP that it took 30 years ago. According to the latest projections from the Congressional Budget Office, that spending will continue to grow at a remarkable pace, taking up half of GDP by 2082. While that happens, spending by Medicare and Medicaid will climb from where it is today, about 4 percent of GDP, to almost 20 percent. At that point, Medicare and Medicaid will demand about the same share of GDP that the entire federal government takes today.

For some time, the story that has defined the popular discussion of this problem is that the phenomenon is inevitable given the "aging of the baby boomers." Afascinating recent report by the CBO exposes this view as an urban myth. In that report, the staff breaks the increase down between two factors, demographics and excess cost ...

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