A lot has changed in the past decade — a recession, a recovery, the passage and implementation of a landmark health care law. But some things you can always count on — like health care spending continuing to climb steadily higher every year.

The big picture: Per-person health care spending rose by 44%, or about 4% per year, from 2007 to 2016, according to new research published in Health Affairs.

• This analysis only includes employer-based health insurance, making the Affordable Care Act a less significant factor. It also doesn’t include premiums — just spending on actual care.

Warning sign: Spending growth slowed immediately after the recession but is now increasing at roughly pre-recession levels.

Winners: Doctors and outpatient hospital facilities drove the bulk of the spending increases, followed by inpatient hospital care.

Deductibles have also risen over the same time period. So, not only are costs going up, but workers are spending more of their own money, out of pocket, to cover those costs.