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Evidence-Based

Healthcare
by the Numbers

Every chart on this page is cited, sourced, and updated. This is not opinion — it is the documented record of how American healthcare got here, and where it’s going.

01

The Living Data

Updated annually from government sources. Come back every year — these numbers get worse.

The Hidden Cost

What Your Family's Insurance Actually Costs

Total annual premium — employer + employee combined — for a family of four. Inflation-adjusted to 2024 dollars. Most Americans only see their paycheck deduction.

Source: KFF Employer Health Benefits Survey (1999–2024); BLS Consumer Expenditure Survey (pre-1999); projection based on CBO actuarial growth assumptions. All figures inflation-adjusted to 2024 USD via BLS CPI.

Administrative Waste

The Waste Machine

Healthcare administrative overhead as a percentage of total health spending. The US spends more on paperwork than most countries spend on actual care.

$800,000,000,000 per year. In administration alone.

Source: CMS National Health Expenditure Data; Himmelstein & Woolhandler, NEJM (2019); Commonwealth Fund international comparisons.

Where This Is Going

The Trajectory

Healthcare as a percentage of US GDP, 1960–2024, with CBO baseline projection to 2035. The dashed line assumes no policy change.

Source: CMS National Health Expenditure Data (historical); CBO Long-Term Budget Outlook (projection, updated annually).

Healthcare Fraud

The Fraud Tax

Annual healthcare fraud recovered by DOJ and HHS OIG. Note: recovered fraud is estimated at less than 10% of total fraud committed.

Source: HHS Office of Inspector General Annual Report; DOJ Health Care Fraud Unit.

Geography of Pain

Where You Live Determines What You Pay

Medicare per-capita spending by US county. Spending varies by 2–3x across counties — driven by market concentration, not health outcomes. Hover a county to see its figure.

Source: CMS Geographic Variation in Medicare Spending; Dartmouth Atlas of Health Care.

Happening Now

Today's Evidence

Updated daily. Sourced from KFF Health News, STAT News, ProPublica, and Modern Healthcare.

02

How We Got Here

The eight policy decisions that built the most expensive healthcare system in the world. Each one has a year, an origin, and data showing what it cost you.

Chapter 1 — 1942

The Accident That Chained Healthcare to Your Job

Employer-sponsored insurance as a share of total US coverage, 1940–2024. A wartime wage freeze in 1942 — nobody voted for this.

Source: KFF Employer Health Benefits Survey; Census Bureau health insurance historical data.

Chapter 2 — 1965

Medicare's Hidden Cost Engine

US healthcare spending as a percentage of GDP, 1960–2024. Fee-for-service reimbursement rewards volume, not outcomes.

Source: CMS National Health Expenditure Data.

The Appeal Paradox

0.1%

of denied patients actually appeal. The system relies on your exhaustion.

Chapter 3 — 1974

The ERISA Loophole — Denial Rates by Insurer

Claim denial rates by major insurer in ACA marketplace plans. Most people give up when denied. That's the business model.

Source: KFF Analysis of ACA Marketplace Denial Rates.

Chapter 4 — 1973

The Prior Authorization Machine

Medicare Advantage prior authorization requests submitted annually, 2019–2024. Growing every year.

Source: CMS Medicare Advantage Prior Authorization Data.

Chapter 5

The Death of the Independent Doctor

Percentage of physicians in independent practice vs. employed by a hospital or corporate entity, 2000–2024.

Source: AMA Physician Practice Benchmark Survey.

Chapter 6 — 2010–2024

Wall Street's $1 Trillion Plunder

Private equity healthcare deal volume by year, 2010–2024. Sick people can't shop around. Wall Street noticed.

Source: PitchBook private equity healthcare data as cited in JAMA / NEJM academic studies on PE healthcare acquisitions.

Chapter 7

The Lobbying Machine

Pharmaceutical industry R&D spend vs. marketing and administrative spend, 2010–2023. Then: the same drug, US price vs. Canada.

Source: SEC annual filings; RAND Drug Pricing Research; OpenSecrets Healthcare Industry Lobbying.