US Health Care Spending: Who Pays?

Josh Cothran

Over the past 55 years, the way health care is financed has changed, with public insurance paying for more care. This graphic shows who paid for health care and how much it cost.

September 2017

Over the past 55 years, there have been major shifts in how we pay for hospital care, physician services, long-term care, prescription drugs, and other health care services and products in the US. In 1960, Medicare and Medicaid did not yet exist. Only half of hospital care was covered by insurance, with the rest paid out of pocket and by a patchwork of local sources, both private and public. Almost all (96%) of spending on prescription drugs came out of the consumer's pocket in 1960, but by 2015, out-of-pocket spending was down to 15%. This interactive graphic uses data from the US Centers for Medicare and Medicaid Services (CMS) to show national spending trends from 1960 to 2015 for health care by payer. (Figures presented refer to personal health care, which, as defined by CMS, includes goods and services such as hospital care and eyeglasses, but excludes administration, public health activity, and investment.)

The data visualization below is a companion to Health Care Costs 101, part of CHCF's California Health Care Almanac.

Note: Data for this visualization were updated September 2017 with 2015 data.