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By the numbers: U.S. health spending and income

Growing disparity in health expenditures between wealthy, middle class

By Matt Wynn

There was no dearth of studies, columns, and thinkpieces exploring the slowdown in healthcare costs for the decade starting in 2004.

But the slowdown didn't affect everyone equally, according to a report in the July issue of Health Affairs, and the result is a growing disparity in health expenditures. Samuel L. Dickman and others looked at average annual healthcare costs for each of five income brackets. They found that the top quintile continued to see rapidly rising costs, the middle class held relatively steady, and the lower class actually had costs decrease.

Doctors are likely performing more services or more expensive services for the wealthiest clients.

To the authors, the finding illustrates that more medical services are going to the group with the least need.

"The pattern of sharply rising spending for the wealthy and flat or slow growth for others mirrors the widening gap in the consumption of other goods and could represent a shift from need-based to income-based receipt of medical care. We fear that it might presage deepening disparities in health outcomes," they wrote.

Figures are inflation-adjusted in 2012 dollars. They are also adjusted for age and health.

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