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Expand chart
Data: Centers for Medicare & Medicaid Services and CIA World FactBook; Note: All values adjusted for inflation as of 2018; Chart: Harry Stevens/Axios

Americans spent $3.65 trillion on health care in 2018, according to new preliminary estimates from independent federal actuaries. That total is about the same size as Spain and Canada's entire economies — combined.

Why it matters: U.S. health spending last year was 4.4% higher than in 2017, a rate that is still growing faster than the broader economy — which means more money is being taken out of people's paychecks to pay for a system that continues to worry and frustrate patients.

By the numbers: That $3.65 trillion health care tab last year translates to $11,121 per person.

  • Spending on hospitals, doctors and other clinic services was $2.16 billion, holding steady at 59% of total health care spending.
  • The spending category that experienced the largest year-over-year increase was the general cost of administering health insurance, which rose 7.7% in 2018.
  • Spending on prescription drugs purchased in retail pharmacies went up 3.3% in 2018, higher than the 0.4% rate in 2017.
  • A majority of the bigger spending totals were due to higher overall prices, while the "use and intensity" of health care services played a smaller role.

Three main conduits pay for health care services: Medicare, Medicaid and private health insurance.

  • Private health insurance continues to fare the worst on controlling costs. Per-person spending among the privately insured rose 4.5% in 2018 despite the fact enrollment in private plans stayed flat.
  • Per-person spending in Medicaid and Medicare increased 1.1% and 3.1%, respectively, last year. Those government programs pay lower provider rates than private insurers.

Go deeper

Updated 1 hour ago - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Politics: Fauci says he accepted Biden's offer to be chief medical adviser "on the spot" — The recovery needs rocket fuel.
  2. Economy: U.S. economy adds 245,000 jobs in November as recovery slows — America's hidden depression: K-shaped recovery threatens Biden administration.
  3. Education: Devos extends federal student loan relief to Jan. 31
  4. States: New Mexico to allow hospitals to ration coronavirus medical care
  5. Vaccine: What vaccine trials still need to do.
  6. World: UN warns "2021 is literally going to be catastrophic"
  7. 🎧 Podcast: Former FDA chief Rob Califf on the vaccine approval process.
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We all know, it’s getting worse.

Reality check: Here are a few things every one of us can do to stay safe and sane in coming months:

Biden's debut nightmare

President-elect Biden speaks in Wilmington on Nov. 24. Photo: Chandan Khanna/AFP via Getty Images

A dim, gloomy scene seems increasingly set for Joe Biden's debut as president.

The state of play: He'll address — virtually — a virus-weary nation, with record-high daily coronavirus deaths, a flu season near its peak, restaurants and small businesses shuttered by wintertime sickness and spread.

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