Picture of health: Stats provide glimpse into health spending


GRAND FORKS, N.D. — National health care spending is on the rise.

According to the federal Centers for Medicare and Medicaid Services, the sector hit $3.3 trillion in 2016, amounting to almost 18 percent of the national GDP for that year after an increase of about $100 billion from 2015.

As a whole, the U.S. spent about $10,350 per person on health care last year. But the statistics don't always tell an entirely consistent story, at least not when observers are pulling out data points to tell more specific stories. That isn't uncommon, said Brad Gibbens, who is deputy director of the UND Center for Rural Health.

"Sometimes sources cut the data differently," Gibbens said. "It can look like a whole different picture sometimes, so part of the story can be health care is complex and data involved is complex."

For example, take a recent CMS national breakdown. The federal centers place North Dakota in a leading position on a handful of metrics as of 2014, including as the state with the highest Medicaid expenditures per enrollee at a sum of $12,413.

The CMS also identified North Dakota as having the most rapid annual growth in personal health care spending through the period of 2009-14, with expenditure increases hitting an average of 6.7 percent each year. Even with the upswing, the state still ranked among the lowest overall contributors to the national spending total, an unsurprising statistic given the state's low population.

Maggie Anderson, director of Medicaid services for North Dakota, said her agency's numbers show a rise in spending over the past few years. The state Legislature approved increases to payment rates for health care providers who work with Medicaid, which lifted spending while maintaining the existing pool of services.

Maybe more significant, North Dakota lawmakers also approved the Medicaid expansion, which Anderson said added a new coverage category of people that boosted the program's rosters by about 20,000 recipients.

According to data provided by the state Insurance Department, all but 8 percent of North Dakotans accessed health care through insurance by 2016.

The department cites numbers from the U.S. Census and the health-focused Kaiser Family Foundation to come up with its total rate of 92 percent insured. That total is broken down into three streams: Employer-sponsored insurance, which accounts for 55 percent; public programs such as Medicare and Medicaid, which make up 29 percent; and individually purchased, such as through the ACA marketplace, which includes 8 percent.

Minnesota can boast an even lower rate of uninsured people. As of 2015, the state uninsured rate was 4.2 percent, down by almost half from the 2013 rate.

As with the national economy, health care makes up a substantial portion of the state economies in both North Dakota and Minnesota.

The North Dakota Compass project compiles economic and other social indicator data through the Center for Social Research at North Dakota State University. According to the Compass, the health care and social assistance sector made up 7.2 percent of the state's total GDP in 2016. The Minnesota version of the compass, which provided the inspiration for its western analog, states that one-quarter of the state's jobs are found in a combined sector of health care and education.