Notes: Personal health care expenditures are spending for health care services, excluding administration and net cost of insurance, public health activity, research, and structures and equipment. Out-of-pocket health insurance premiums paid by individuals are not included in Consumer Out-of-Pocket; they are counted as part of Private Health Insurance. Medicaid spending for the State Children's Health Insurance Program (which began in 1998) is included in Other Government Programs, not in Medicaid. With the 2004 estimates, the Centers for Medicare and Medicaid Services (CMS) incorporated new concepts, methods, and data sources in the National Health Expenditure Accounts and revised the entire time series back to 1960. According to CMS, the most important revisions were the introduction of estimates of investment in medical equipment and software, expanded estimates of investment in medical-sector structures, and the use of updated data from the U.S. Census Bureau’s 2002 Economic Census and other sources. Overall, these changes raised the estimates of health spending 3-4% for nearly all years prior to 2004.

Source: Kaiser Family Foundation calculations using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, at http://www.cms.hhs.gov/NationalHealthExpendData/ (see Historical; National Health Expenditures by type of service and source of funds, CY 1960-2004; file nhe2004.zip).