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A healthy appetite for health care?

How supply and demand may affect the costs and consumption of health care services

Health care has improved considerably in the past couple of decades, in terms of both quality and access. Yet, with health care costs on the rise in recent years, it’s also a topic of many heated discussions. Supply factors could be behind the increase in costs for health care services, but would also have a negative impact on their demand. On the other hand, higher demand for health care services would increase both the price and quantity consumed.

With FRED’s personal consumption expenditures price index data, we use the graph above to show the ratio of the price index for health care services to the overall price index for all goods and services in the economy. (The base year is set to 1999.) We can see that health care services are about 10 percent more expensive today, relative to all other goods and services, than they were 18 years ago.

The graph below shows, in billions of chained 2009 dollars, the amount spent on health care as a share of total consumption spending. (It’s important to keep in mind that the series displayed here mute the effect of changes in the price levels, as prices are “fixed” to the levels in 2009.) We can see an increasing trend for the past 18 years, indicating that the amount of health care consumed, as a share of total expenditures, has also been rising. This also implies that consumer spending on health care has been increasing more than consumer spending on other types of goods.

These graphs suggest that some demand factors could be behind the increased cost of health care, as both the price and the consumption of health care services, relative to other components of consumption, have increased. Some possible demand factors could be related to longer life spans, the demand for newer and more expensive procedures, and so on. Our analysis here is stylized, but further research should look at this issue more closely to try to illuminate the supply and demand factors behind the rising cost of health care.

How these graphs were created: For the first graph, search for “Personal Consumption Expenditures: Services: Health care (chain-type price index)” and select the quarterly, seasonally adjusted series. From the “Edit Graph” section, under “Units,” select “Index (Scale value to 100 for chosen date)” and set the date to 1999-01-01. Then use the “Add Line” option to add the quarterly and seasonally adjusted series for “Personal Consumption Expenditures (chain-type price index).” Apply the same adjustment to set the index to 100 for 1999-01-01. Then apply the formula a/b. Set the starting date for the graph to 1999-01-01. For the second graph, search for “Real Personal Consumption Expenditures: Services: Health care” and select the quarterly, seasonally adjusted series. Then, from the “Edit Graph” section, use the “Add Line” option to search for “Real Personal Consumption Expenditures,” quarterly, seasonally adjusted. Then apply the formula a/b.

Suggested by Maximiliano Dvorkin and Asha Bharadwaj.

View on FRED, series used in this post: DHLCRG3Q086SBEA, DHLCRX1Q020SBEA, PCEC96, PCECTPI

Healthy inflation?

Inflation in the healthcare industry vs. general CPI

Some components of the consumer price index have consistently, over several decades, risen faster than the rest. This blog recently discussed education as one such component. The components of the CPI devoted to medical care have also seen faster price increases than the rest of the basket. Going back as far as the series are available, since 1948, the price of medical care has grown at an average annual rate of 5.3% while the entire basket, headline CPI, has grown at an average annual rate of 3.5%. In the past 20 years, in the regime of stable inflation, headline CPI has grown at an average annual rate of 2.2%, whereas the price level of medical care has grown at an average annual rate of 3.6%—about 70% faster.

The graph above shows the two time series. Besides the difference in their levels, it’s also notable how much less cyclical medical care inflation is. Although overall CPI inflation dips during recessions, medical care inflation stays steady.

The implication of these two features is far reaching: It’s symptomatic of the increasing share of income the U.S. spends on medical care. Beyond macro trends, the features of these two series themselves have policy implications. Indeed, indexing government healthcare budgets to overall CPI rather than medical care prices has implications for spending in real terms. This gap could also widen during recessions, when government help may be most in demand.

The CPI is intended to measure the price of goods consumers purchase directly, and therefore the medical care subset is actually measuring only the prices of out-of-pocket expenses. For healthcare, however, there’s a great deal of other spending going on. And the inflation rate of that spending is something a policymaker might need to know. Luckily, the BEA puts together a more holistic price index for healthcare spending—the health expenditures price index—which we add in the graph below. Although the history of this series is shorter, this measure of healthcare prices is still rising considerably faster than headline CPI: In 2001-2013, this measure of healthcare inflation rose almost 4% per year, whereas headline CPI rose 2.3% in this period and the other healthcare CPI rose 3.9%.

How these graphs were created: For the first graph, search for “Consumer Price Index Medical.” In the “Edit Graph” tab, convert the units to “Percent Change from a Year Ago.” Then use the “Add Line” feature to search for “Consumer Price Index All Items.” Add this line and again check that its units are the same. (FRED does this automatically, but it doesn’t hurt to check.) These series are both also available as chained indices, but for a shorter period. For the second graph, add to the first another line by searching for “Health Expenditures Price Blended Account.” Then restrict the period to show the entirety of the new line.

Suggested by David Wiczer.

View on FRED, series used in this post: CPIAUCSL, CPIMEDSL, HLTHSCPIBLEND

To your health! The price of French wine

Today, France celebrates its national holiday. So we take this opportunity to write about… French wine. Oui. FRED does have a price index for French wine. And because prices are always relative to something else, we compare this index with the general price level of consumption goods in France (the blue line). We see that, in relative terms, the price of wine has increased, which sounds bad for the local population. But we can also compare the price of wine with the typical French hourly wage (the red line): There we see that wine has become more and more affordable for the French, which is a reason to celebrate.

How this graph was created: Search for “French wine” and open the graph. In the “Edit Graph” panel, add France’s general price index in the “Customize Data” section. Searching for “France CPI” should do the trick. Once you have both series, apply the formula a/b. In the “Add Line” tab, search again for “French wine” (which may appear among your recently viewed options). Then under “Edit Line 2” add the wage series by searching for “French wage.” Choose the quarterly series for all activities and apply the same a/b formula again. Viola!

Suggested by Christian Zimmermann.

View on FRED, series used in this post: CP0000FRM086NEST, CP0212FRM086NEST, LCWRTT01FRQ661N

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