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Expand chart
Data: Centers for Medicare & Medicaid Services' Office of the Actuary; Chart: Axios Visuals

Americans spent $3.65 trillion on health care in 2018 — 4.6% more than the year before. That growth also was higher than the 4.2% rate from 2017, according to revised figures from independent federal actuaries.

Between the lines: U.S. health care spending climbed again not because people went to the doctor or hospital more frequently, but because the industry charged higher prices. And private health insurers didn't do a particularly good job negotiating lower rates.

By the numbers: The 4.6% growth rate in 2018 was revised up slightly from preliminary numbers released in February, and it came in below the broader economic growth rate.

  • All other figures on what Americans spent on hospitals, doctors and prescription drugs sold at pharmacies also were similar to February's report.

The intrigue: The number of people with private health plans — which mostly consists of the coverage people get through their jobs — dipped in 2018, yet the amount spent per person soared 6.7%.

  • That is the highest per-enrollee spending growth rate among people with private health insurance since 2004, actuaries wrote.
  • Part of that increase was due to higher premiums that insurance companies passed on from the Affordable Care Act's health insurance tax.
  • More importantly: Hospitals, doctors and drugmakers continued to wring out much higher rates from private insurers thanks to provider mergers and perverse negotiating incentives.

Medicare and Medicaid had much lower per-enrollee spending growth rates in 2018 than private insurance, but those figures were the highest they've been since 2015 — again due to higher costs for the private insurers that are increasingly running those government programs.

Go deeper

1 min ago - Health

A safe, sane survival guide

Photo: Luka Dakskobler/SOPA Images/LightRocket via Getty Images

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 nightmare debut

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.

Using apps to prevent deadly police encounters

Illustration: Sarah Grillo/Axios

Mobile phone apps are evolving in ways that can stop rather than simply document deadly police encounters with people of color — including notifying family and lawyers about potential violations in real time.

Why it matters: As states and cities face pressure to reform excessive force policies, apps that monitor police are becoming more interactive, gathering evidence against rogue officers as well as posting social media videos to shame the agencies.