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have improved dramatically in ways not accounted for in major price indices. As a result, these indices dramatically overstate the extent to which rising medical prices are making people worse off over time. As a final note, to the degree that statistical agencies have gotten better at measuring quality improvements over time, long-term comparisons of health care price inflation can be misleading. Indeed, it is possible that some of the long-term decline in health care price inflation depicted in Figure 4-2 results from methodological improvements of this kind. However, methodological improvements of this kind are unlikely to play a substantial role over short time periods, and they likely play little or no role in explaining the sharp declines in health care price inflation over the last few years. in private insurance over the 2010-13 period is less than one-quarter its level from 2000-07 and less than one-third its level from 2007-10. The change in Medicare spending growth has been similarly dramatic, with real growth in per beneficiary Medicare costs essentially ceasing over this period. In Medicaid, the already slow growth in real per beneficiary costs seen in recent years has continued and turned slightly negative from 2010 to 2013. The slowdown is similarly broad-based when looking across spending categories. Real per capita growth in spending on hospital care—the largest single category of spending, accounting for almost one-third of total spending—is growing at less than half the long-term historical average rate and more than 1 percentage point slower than the most recent historical period. Prescription drugs have seen particularly sharp reductions in growth, with spending actually shrinking in real per capita terms at a 1.3 percent annual rate over the last three years. Physician and clinical services and home health and skilled nursing care show similarly slow growth rates in a historical context. Panel A of Table 4-2 documents a similar slowdown in the growth of prices paid for health care goods and services, which is also depicted in Figure 4-2. Health care inflation, whether measured using the personal consumption expenditure (PCE) price indices or the CPI for medical care, is running at half or less the rate seen historically, and below the rates seen over the last decade. Indeed, year-over-year inflation as measured using PCE data is currently running at around 1 percent, a level last seen in 1963. The recent behavior of the CPI for medical care is similar, with recent months’ year-over-year inflation rates reaching low levels not seen since 1972. It is important to note that this slow growth in prices for health care goods and services is not simply a reflection of the fact that the prices of all goods and services have grown slowly in recent years. Panel B demonstrates Recent Trends in Health Care Costs, Their Impact on the Economy, and the Role of | 153 the Affordable Care Act
Figure 4-1 Growth in Real Per Capita National Health Expenditures, 1961–2013 Annual percent change 8 7 6 5 4 3 2 2013 1 0 1960 1970 1980 1990 2000 2010 Note: Data for 2013 is a projection. Source: Centers for Medicare and Medicaid Services, National Health Expenditure Accounts; Bureau of Economic Analysis, National Income and Product Accounts; CEA calculations. Figure 4-2 General and Health Care Price Inflation, 1960–2013 12-month percent change 14 12 10 PCE for Health Care Goods and Services 8 6 Dec-2013 4 2 0 PCE for All Goods and Services -2 1960 1970 1980 1990 2000 2010 Source: Bureau of Economic Analysis, National Income and Product Accounts; CEA calculations. 154 | Chapter 4
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ECONOMIC REPORT OF THE PRESIDENT To
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C O N T E N T S ECONOMIC REPORT OF
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economic report of the president To
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year-old. In the meantime, I’m go
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the annual report of the council of
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C O N T E N T S CHAPTER 1. PROMOTIN
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APPENDIX 1: COMPONENTS OF THE RECOV
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THE OBAMA ADMINISTRATION’S RECORD
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2.15. Housing Starts, 1960-2013....
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3.1. Forecasted and Actual Real GDP
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C H A P T E R 1 PROMOTING OPPORTUNI
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Opportunity, Growth, and Security i
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crisis—continue to rebound and co
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Figure 1-4 Real GDP Per Working-Age
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Figure 1-6 Change in Poverty Rate F
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Figure 1-7 Domestic Crude Oil Produ
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Figure 1-8 Growth in Real Per Capit
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Figure 1-9 Unemployment Rate by Dur
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e needed to make up for a decades-l
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Annual percent change 2.50 15-year
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Figure 1-14 Share of National Incom
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Along with steps that create jobs,
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corner, with purchases increasing d
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the four quarters of 2013, or enoug
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Percent of GDP 12 10 8 6 4 2 0 -2 -
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Percent 5.0 4.0 3.0 2.0 Figure 2-3
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In the euro area, the unemployment
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Figure 2-6 Cumulative Flows into Mu
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Figure 2-7 Household Deleveraging,
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Box 2-1: The 2013 Comprehensive Rev
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Percent 25 20 15 10 5 0 -5 Figure 2
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Figure 2-11 State and Local Pension
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Percent of GDP 2 1 0 Figure 2-14 Cu
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Box 2-2. Administration Trade Polic
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Upon completion, the TPP and T-TIP
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percent of households report that i
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Figure 2-18 Petroleum Net Imports,
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Figure 2-21 U.S. Per Capita Consump
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Percent 11 Figure 2-22 Unemployment
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Figure 2-25 Predicted vs. Actual Ma
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Box 2-4: Unemployment Duration and
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The Long-Term Outlook The 11-Year F
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Growth in GDP over the Long Term As
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Box 2-5: Immigration Reform and Pot
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Even with this growth, however, the
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families. The other half was for in
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ecause of rapidly declining stock a
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Obama Administration and the 111th
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Figure 3-1 Recovery Act Programs by
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other cases, new measures expanded
Page 107 and 108: Figure 3-2 Recovery Act and Subsequ
Page 109 and 110: Box 3-1: Other Administration Polic
Page 111 and 112: challenges, and how economists have
Page 113 and 114: Table 3-5 Estimated Output Multipli
Page 115 and 116: Figure 3-7 Quarterly Effect of the
Page 117 and 118: Table 3-6 Estimates of the Effects
Page 119 and 120: International Comparison The 2008 c
Page 121 and 122: Box 3-2: The U.S. Recovery in Compa
Page 123 and 124: Table 3-7 Tax Relief and Income Sup
Page 125 and 126: traditionally been jointly financed
Page 127 and 128: downturn in the economy. Even thoug
Page 129 and 130: Figure 3-11 Recovery Act Cumulative
Page 131 and 132: The Recovery Act also invested in r
Page 133 and 134: helped individuals who chose to ret
Page 135 and 136: the period, even though total power
Page 137 and 138: average—then the resulting increa
Page 139 and 140: Alternative Minimum Tax relief, bus
Page 141 and 142: Through the end of a Individual Tax
Page 143 and 144: y Poterba (1994), states and locali
Page 145 and 146: Table 3-11 Fiscal Support for the E
Page 147 and 148: spells. Because the resulting unemp
Page 149 and 150: literature uses two different appro
Page 151 and 152: Table 3-12 Summary of Cross-Section
Page 153 and 154: the CMS projections show real per-c
Page 155 and 156: will accrue to workers as higher wa
Page 157: Box 4-1: Two Measures of Growth in
Page 161 and 162: in particular may not exactly track
Page 163 and 164: find that even those seniors who di
Page 165 and 166: the slowdown in real (that is, infl
Page 167 and 168: health care costs for an individual
Page 169 and 170: estimate for the ACA found that its
Page 171 and 172: Figure 4-4 Medicare 30-Day, All-Con
Page 173 and 174: agreements among the providers them
Page 175 and 176: payment for physician services, the
Page 177 and 178: Box 4-3: The Cost Slowdown and ACA
Page 179 and 180: 2010a; 2011; 2012c; 2013a; 2014), w
Page 181 and 182: Figure 4-6 Recent CBO Projections o
Page 183 and 184: Conclusion The evidence is clear th
Page 185 and 186: facilitated this private-sector tec
Page 187 and 188: esulting gap between the actual gro
Page 189 and 190: Table 5-1 Sources of Productivity I
Page 191 and 192: Table 5-2 Nonfarm Private Business
Page 193 and 194: of the productivity improvement res
Page 195 and 196: Figure 5-3 Growth in Productivity a
Page 197 and 198: improving and college completion ra
Page 199 and 200: Box 5-2: Does Inequality Affect Pro
Page 201 and 202: Percent 3.5 Figure 5-5 Composition
Page 203 and 204: • Just two of the largest U.S. te
Page 205 and 206: Box 5-3: Just-in-Time Manufacturing
Page 207 and 208: Figure 5-7 Exclusive and Shared All
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Box 5-4: Spectrum Investment Polici
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To stimulate investment in more adv
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Because current uses of technology
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Box 5-5: Electronic Health Records
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about the array of services and sup
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and, in such cases, provides partie
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Box 5-6: The Leahy-Smith America In
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Box 5-7: Pay-For-Delay Settlements
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C H A P T E R 6 THE WAR ON POVERTY
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Measuring Poverty: Who is Poor in A
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thresholds ever since. These dollar
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of necessary items, including food,
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Table 6-1 Poverty Rates by Selected
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Box 6-3: Women and Poverty While wo
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However, this reflects smaller decl
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Percent 25 Figure 6-1 Trends in the
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Box 6-4: Social Programs Serve All
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of low- and middle-income workers a
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particularly valuable since they es
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Figure 6-4 Official vs Anchored Sup
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deep market poverty driven by the b
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work: in 2010, for example, unemplo
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out of poverty through job training
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e noted that researchers have found
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2012). Among the children of low-ea
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Education appears to be one of the
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Friedman, and Rockoff (2011) find t
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including an additional $25 a week
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Figure 6-11 Recovery Act and Subseq
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Empowering Every Child with a Quali
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modernize America’s high schools
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low-income Americans and their chil
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C H A P T E R 7 EVALUATION AS A TOO
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program evaluation efforts. For exa
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went to preschool would have had if
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y adopting successful interventions
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Box 7-2: Using Behavioral Economics
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Box 7-3: “Rapid Cycle” Evaluati
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Figure 7-1 Outlays for Grants to St
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performance data, fewer than half o
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Investment Act programs. The PROMIS
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Figure 7-2 Inventory of Beds for Ho
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example, included a nondiscretionar
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Other benefits of considering evalu
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with the treatment effect and thus
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unemployment insurance wage and ben
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hard for researchers to access for
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REFERENCES Chapter 1 Almunia, Migue
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____. 2014. “Press Release: Janua
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and the TPP at the Peterson Institu
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Increase Employment Evidence from t
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___. 2010b. “The Economic Impact
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___. 2012. World Economic Outlook A
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Polak Annual Research Conference. W
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Baicker, Katherine and Amitabh Chan
Page 320 and 321:
Daly, Mary, Bart Hobijn, and Brian
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Nominal Wages,” International Jou
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Learning: A Meta-Analysis and Revie
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Chien, Colleen V. 2012. “Reformin
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GAO (Government Accountability Offi
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Jorgenson, Dale. 2001. “Informati
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Integration in Economic Development
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_____. 2007. “Improving the Safet
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Dahl, Gordon B. and Lance Lochner.
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Heckman, James J. and Dimitriy V. M
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Ludwig, Jens and Douglas Miller. 20
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Sharkey, Patrick. 2009. “Neighbor
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_____. 2013. “Practical Evaluatio
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www.nij.gov/topics/corrections/comm
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Stock, James H., and Mark Watson. 2
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letter of transmittal Council of Ec
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Council Members and Their Dates of
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The Members of the Council Betsey S
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Act has had on reducing health care
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Statistical Office The Statistical
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A P P E N D I X B STATISTICAL TABLE
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INTEREST RATES, MONEY STOCK, AND GO
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2013-to-2014 TABLE NUMBER MATCH 201
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Year or quarter Table B-1. Percent
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Table B-2. Gross domestic product,
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Table B-3. Quantity and price index
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Table B-5. Real exports and imports
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Year Total 2 Table B-7. Real farm i
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Table B-9. Median money income (in
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Year or month Civilian noninstituti
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Year or month All civilian workers
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Table B-14. Employees on nonagricul
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Table B-15. Hours and earnings in p
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Year and month Interest Rates, Mone
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Year and month Table B-18. Money st
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Table B-20. Federal receipts, outla
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Table B-22. Federal receipts, outla
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Table B-24. State and local governm
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End of month Table B-26. Estimated
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B-7. Chain-type price indexes for g
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B-28. National income by type of in
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B-48. Employment cost index, privat
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B-65. Producer price indexes by sta
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B-81. Federal receipts, outlays, su
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B-99. Farm output and productivity
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B-111. International reserves Inter
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