Hospital expenditures helped push U.S. health care spending to $1.3 trillion in 2000, a jump of nearly 7 percent over 1999 that experts said signals an end to a decade of stable cost growth.
"The sudden jump in spending came as somewhat of a surprise," Robert Field of the University of the Sciences in Philadelphia told UPIl. "The trend through most of the 1990s was to keep health care inflation in line with overall inflation. What appears to have happened in 2000 is that it jumped ahead."
Rising costs for hospital care, drugs, medical technology and labor, along with managed care's inability to squeeze out any additional savings from a once-bloated and now much leaner industry, all helped to push health care spending to 13.2 percent of the gross domestic product for 2000. It is the second year in a row it outpaced GDP growth, ending a nine-year stint in which it echoed the comparison rate rise, which continued to slow.
"We expect health care costs will continue to grow faster than the economy," said Katharine Levit, director of the Centers for Medicare and Medicaid's National Health Statistics Group.
Hospitals -- which had tightened their belts through consolidations and mergers to form more powerful networks and systems -- emerged from the strict confines of managed care to use their new leverage to negotiate higher payments from managed care plans, which were forced to ease restrictions because of the public backlash and a threat of congressional action via patients' rights legislation.
"Consumers will be paying more as premium costs increase," Cynthia Smith, economist with the CMS National Health Statistics Group, said. "They are accelerating and they may face benefit packages that look slightly different. The content of those benefit packages will vary in the ability of their employers to provide them ... and more sharing of health care costs will result."
Field said the bottom line could mean employers drop managed care or fee-for-service plans and opt for a new way to control premium increases. The leading proposal, being test driven in a few large markets such as New York, is called a defined contribution plan. The employer sets aside a fixed amount of money for health care for each employee, without the promise it will buy all the insurance coverage employees may wish to have.
Labor also helped drive up hospital costs. Faced with a severe shortage of nurses, radiologists and other professional staff, the CMS report said weekly wages in private hospitals grew 4.1 percent in 2000, up from 2.3 percent in 1999. Physicians also joined together in networks to wield more bargaining power with hospitals and insurers, according to the report, published in the January/February 2002 issue of the journal Health Affairs.
(Thanks to UPI's Ellen Beck in Washington)
EARLY CHILDHOOD EDUCATION
States are providing more early childhood education programs, but gaps in quality and access remain for the nation's 11.9 million children under age five.
That's according to a 50-state study released Monday by Education Week, a national education newspaper.
"Although all states provide child care subsidies for at least some poor families, wide variations exist in the income limits that families must meet to qualify, the actual dollar amount of the subsidies, and the percentage of eligible children served," the report said. "Families with low incomes, particularly the working poor, have the least access to high-quality early-childhood services."
The study, funded by Pew Charitable Trusts, also provided its annual report card on the progress the 50 states were making in education accountability and teacher quality. It said that states' financial commitment to early childhood education varies widely, as do eligibility requirements and the number of children who actually receive services.
Although every state subsidizes kindergarten in at least some districts, nine states -- Alaska, Colorado, Idaho, Michigan, New Hampshire, New Jersey, New York, North Dakota, and Pennsylvania -- still do not require districts to offer kindergarten, the study said.
The study said most states focus pre-kindergarten efforts on the neediest youngsters. Twenty-six target children from low-income families; 15 of those also look at other risk factors, such as having a teenage parent. Nine states leave it up to local districts to determine which risk factors they will consider.
The report also said state governments had "a long way to go" to ensure people who work with young children are both well educated and well compensated.
The average salary for child care workers in 1999 was $15,430, the report said, with pre-school teachers working with 3-to-5-year-olds drawing annual salaries of $19,610. That is less than half of what an elementary school teacher earned in the same year. As a result, the turnover rate among early childhood workers is high and education requirements minimal.
NEA President Bob Chase issued a statement, saying early childhood education must be a national priority because that is when the "achievement gap begins."
LOOKING TO THE FUTURE
After the shocks and disasters of 2001, Americans are entering 2002 on a surprisingly upbeat note -- optimistic about the future and strongly supportive of their president. That's according to a national poll conducted for "Louis Rukeyser's 2002 Money Guide," a PBS-TV special that aired last Friday.
The survey of 1,009 Americans, which was conducted by Opinion Research Corporation of Princeton, N.J., found 60 percent thought 2001 was not a good year for the United States, while 68 percent didn't think 2001 was a good year for them personally. 80 percent think 2002 will be a better year for the U.S., while 82 percent think 2002 will be a better year for them.
75 percent of those questioned think the United States is moving in the right direction. About the same percentages are optimistic about the future of the United States (84 percent) and their own future (85 percent).
And three-quarters (75 percent) think President Bush has done a good or excellent job.
(Web site: pbs.org/rukeyser)
ACTORS GUILD ELECTION TO BE RERUN
The Screen Actors Guild National Elections Committee has thrown out the results of the union's recent election of top officers because of irregularities in the way balloting was conducted.
The panel ordered that the election of SAG's president, recording secretary and treasurer be rerun "promptly," with ballots mailed to SAG members on or before March 15, and a cut-off for receipt of ballots in Los Angeles no later than April 10. The panel -- chaired by Fred Savage, best known as the star of the TV series "The Wonder Years" -- said its decision is the last word in the matter.
The ruling follows an investigation by the committee -- which supervises SAG elections -- into 20 formal challenges to the election results. The two major complaints alleged that last October's election was marred because voters in the union's New York branch had two more days than voters elsewhere to return their mail-in ballots, and because ballots used by voters in New York were different from those used everywhere else.
Two of the challenges were filed by candidates who won election to national office -- Elliot Gould (Recording Secretary) and Kent McCord (Treasurer).
Placing the blame for the faulty election squarely on SAG senior staff and Sequoia Voting Systems, a private firm that has administered the union's elections for years, the elections committee called the candidates "innocent victims."
The order only affects the election results for the union's top three national officers. The election of 12 national vice presidents will stand because those elections were conducted at the branch level, not nationally.