Health affairs
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We used data from the National Practitioner Data Bank (NPDB) to study the growth of physician malpractice payments. Judgments at trial account for 4 percent of all malpractice payments; settlements account for the remaining 96 percent. ⋯ These increases are consistent with increases in the cost of health care. A preoccupation with data on judgments, extreme awards, or specific specialties results in an incomplete understanding of the growth of physician malpractice payments.
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Obesity is responsible for at least 90 billion dollars in direct U. S. health care costs annually. ⋯ The effects of adverse weight in older age have negative implications for healthy aging and lead to greater societal expenditures. Given the high costs and ineffectiveness of existing programs to treat obesity, perhaps the only solution to the obesity epidemic is primary prevention of weight gain beginning in youth.
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Is the health of the U. S. population improving or getting worse, and how are health and medical costs influenced by obesity? How will anticipated advances in the biomedical sciences influence life expectancy and the cost of health care? The paper by Dana Goldman and colleagues is a daring speculation on the life-extending effects of possible future technologies--a valuable exercise given the speed of technological advances. Darius Lakdawalla and colleagues provide a methodologically solid basis for concluding that not only does obesity kill, it also takes an alarming toll on health and health care spending at levels that require immediate intervention.
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The pace of health spending growth slowed in 2003 for the first time in seven years, driven in part by a slowdown in public spending growth. U. S. health care spending rose 7.7 percent in 2003, much slower than the 9.3 percent growth in 2002. ⋯ U. S. health spending accounted for 15.3 percent of U. S. gross domestic product in 2003, an increase of 0.4 percentage points from 2002.
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The RAND Future Elderly Model illustrates important principles about the relation among medical technologies, health spending, and health. New technologies add to spending because the costs of the new technologies and the health care costs during the added years of life they bring outweigh reductions in annual spending from better health. Many technologies with a low cost per patient per year result in high aggregate costs because of an expanded population being treated. However, the jury is still out on whether a better health-risk profile among future sixty-five-year-olds could moderate health spending for the elderly.