Out-of-pocket health spending.

Reading the chart. Out-of-pocket health spending is what households actually pay directly for healthcare — co-payments, coinsurance, prescription drugs, dental, vision, and services not covered by insurance. It does not include health insurance premiums (those are tracked in the premium charts). The Centers for Medicare & Medicaid Services tracks this aggregate annually in the National Health Expenditure Accounts (NHEA), divided by U.S. population to produce a per-capita figure. Per-capita out-of-pocket spending grew 3.80× from 1987 to 2024 versus CPI 2.76× — approximately 1.38× faster than overall inflation. NHEA is administrative data from claims and household surveys; it is the most comprehensive national measure available. The BLS Consumer Expenditure Survey publishes an alternative household-level measure that we may add as an overlay in a future version.