Apr 11

Past Event

The Future of U.S. Health Care Spending



  • The Role of Health Care Innovation

    Mark McClellan: Improve the U.S. health care system through innovations in health care delivery and biomedical technology.

    Mark B. McClellan

  • The Federal Budget and Health Care Spending

    William G. Gale: Even if health care spending is totally under control over the next 75 years, there's still a federal budget issue. And if federal health care spending grows at anything like a worst case scenario, the budget explodes.

    William G. Gale

  • What Are States Going to Do about Growing Health Care Costs?

    Ray Scheppach, University of Virginia: Some states will probably raise taxes somewhat due to growing health care costs. Some spending will essentially come out of higher education, unfortunately.

  • Who Pays for Health Care Spending?

    Amanda Kowalski, Yale University: If you ask people who pays for increases in health spending, employers say they do. But then if you ask economists, they'd almost all say employees pay.

  • Large Health Spending Programs Crowding the Rest of the Federal Budget

    Douglas Holtz-Eakin, American Action Forum: As large health spending programs and mandatory programs in the budget grow, they are crowding out the rest of the budget. We are seeing the annual discretionary spending that funds national security, basic research, infrastructure, education--the kinds of things our founders would have recognized as the role of government--they are steadily going away.

  • Why Health Care Is Different

    Alice Rivlin: The laws of supply and demand do not apply to health care.

    Alice M. Rivlin

  • Why Healthcare Efficiency Isn't Enough

    Alice Rivlin: Increased health care efficiency may face political challenges in the future.

    Alice M. Rivlin

  • Improving Health Care Efficiency

    David Cutler, Harvard Kennedy School of Government: The health care system can remove inefficiencies by improving the operating system and performance.

Full Event


For several decades health spending in the United States rose much faster than other spending. Forecasters predicted the health sector, already 17% of GDP, would soon exceed 20 to 25% of GDP, driving out other necessary public and private spending. However, in recent years health spending growth dropped dramatically and surprisingly, to a record slow pace for the fourth straight year in 2012. It is not clear why this turn around occurred or how long it will last.

On Friday, April 11th the Engelberg Center for Health Care Reform at Brookings brought together several experts to discuss three questions that will also be addressed in a forthcoming series of Brookings papers. The discussion and papers address the causes of the slowdown and the likelihood it will continue; its impact on federal and state budgets, and private spending; and identify reforms that will ensure slow cost growth while improving health.

Over a dozen economic and health policy experts participated in panel discussions, including Harvard’s David Cutler, American Action Forum’s Douglas Holtz-Eakin, University of Southern California’s Paul Ginsburg, and Altarum’s Charles Roehrig.

Read more about the papers being presented

Event Agenda


April 11, 2014

8:30 AM - 2:15 PM EDT

Brookings Institution

Falk Auditorium

1775 Massachusetts Avenue NW


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For More Information

Engelberg Center Communications