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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

Health care ruling saves Republicans from themselves

Illustration: Aïda Amer/Axios

The Supreme Court saved the health care system from imploding Thursday by dismissing a Republican challenge to the Affordable Care Act. But it also saved the GOP itself from another round of intraparty chaos.

Why it matters: Most GOP lawmakers privately admit (and some will even say publicly) they don't want to deal with health care again. The issue generally isn't a good one for them with voters — as they learned the hard way after they failed to repeal the ACA in 2017.

8 hours ago - Economy & Business

Fed chief's second-term audition

Jerome Powell during a virtual news conference. Photo: Daniel Acker/Bloomberg via Getty Images

Federal Reserve Chairman Jerome Powell faces a long, hot summer audition for a second term, with senators watching and weighing his response to potential signs of inflation.

Why it matters: The financial system's chief is one of the most powerful in the world. President Biden hasn’t given any public indication whether he’ll renominate Powell, but Democrats close to the administration say there's a chance he'll make an announcement by Labor Day — well before Powell’s term ends next February.

10 hours ago - World

Mapping China's growing global influence

Data: Atlantic Council; Map: Andrew Witherspoon/Axios

As of 1980, China was the most influential player in just one country: Albania. Now, China is the leading power across most of sub-Saharan Africa and Southeast Asia and is catching up to the U.S. in its own hemisphere.

What we’re reading: That's according to a new report from the University of Denver and the Atlantic Council that seeks to measure the influence countries have on each other, and in so doing offers a dramatic portrait of China's rise.

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