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Expand chart
Adapted from MedPAC, "Report to the Congress", March 2018; Note: CHIP was created in 1997, only included in 2016 share. Chart: Axios Visuals

Think you’re getting stuck with bigger bills for your routine medical costs, like copayments and deductibles? You might want to look at this chart, based on research from the Medicare Payment Advisory Commission. It shows that, back in 1976, our disco-dancing ancestors paid a way bigger share of own their health care costs than we do today.

Between the lines: If you’re wondering how that can be true, we’ve got some thoughts from Matthew Fiedler of the Brookings Institution, and the MedPAC report has some clues too. The basic answer is that health coverage has gotten more comprehensive than it was 40 years ago.

Yes, but: Out-of-pocket costs don’t include premiums, so it’s possible that we’re just paying for our health care in other ways.

The details:

  • Medicare drug coverage didn’t even exist before 2006, as Fiedler points out. More of the public is now covered through Medicare, Medicaid or CHIP, too.
  • There’s less data available about whether private health insurance has gotten more generous, but look at how much its share of personal health care spending grew. (There are also guardrails now that didn’t exist before the Affordable Care Act, like annual and lifetime out-of-pocket limits.)
  • Over the last decade, the share of costs we pay out of pocket hasn’t changed much. But, Fiedler points out, the dollar amount has, because prices keep rising.
  • The number of people in high-deductible plans has risen, Fiedler notes, so we’re more likely to pay out of pocket earlier than we used to.
  • We’re also not getting paid as much — salary and wage growth have been trimmed so our employers can keep giving us health insurance.

The bottom line: We pay for health care in so many different ways — some hidden, some not — that you’re probably not going to feel much relief even though public and private health coverage has gotten better.

Go deeper

Updated 12 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

Dave Lawler, author of World
26 mins ago - World

Biden holds first phone call with Putin, raises Navalny arrest

Putin takes a call in 2017. Photo: Handout/Anadolu Agency/Getty

President Biden on Tuesday held his first call since taking office with Vladimir Putin, pressing the Russian president on the arrest of opposition leader Alexey Navalny and the Russia-linked hack on U.S. government agencies, AP reports.

The state of play: Biden also planned to raise arms control, bounties allegedly placed on U.S. troops in Afghanistan and the war in Ukraine, according to White House press secretary Jen Psaki, who said the call took place while she was delivering a press briefing. Psaki added that a full readout will be provided later Tuesday.

Biden signs racial equity executive orders

Joe Biden prays at Grace Lutheran Church in Kenosha, Wisconsin, on September 3, 2020, in the aftermath of the police shooting of Jacob Blake. PHOTO: Jim Watson/AFP via Getty Images

President Joe Biden on Tuesday signed executive orders on housing and ending the Justice Department's use of private prisons as part of what the White House is calling his “racial equity agenda.”

The big picture: Biden needs the support of Congress to push through police reform or new voting rights legislation. The executive orders serve as his down payment to immediately address systemic racism while he focuses on the pandemic.