Health care costs are products of eras

“In the ’40s, 68 cents of every health care dollar was actually paid for by the patient, today it’s only 11 cents.” — Sen. Ron Johnson, R-Wis., on June 4 in a television interview

Amid the Senate’s efforts to pass a new health bill, Sen. Ron Johnson, R-Wis., has been adamant that spending on health care must come down.

We examined whether he’s right about the big drop in the percentage of health care costs paid directly by the people served.

The structure of health care has evolved over decades. In the 1940s — the era Johnson cited — as the population moved from rural to urban areas, medical care shifted even more from homes to medical facilities. World War II played a major role in the expansion of health insurance as employers began to boost health insurance benefits to attract workers. After the war, labor unions also played a role, negotiating for better fringe benefits, including health insurance.

Johnson spokesman Ben Voelkel said in an email that the senator was referring to the total of health consumption expenditures and pointed us to a 1971 report: “National Health Expenditures, 1929-70” by Dorothy P. Rice and Barbara S. Cooper. According to that report, what is now called out-ofpocket spending for 1949 was at 67.7 percent. That’s the 68 cents on every dollar Johnson cited.

Our rating

The numbers Johnson cited track with studies and official statistics. But Johnson is comparing two vastly different eras in health care, including one from a period when fewer people were covered by health insurance and thus paid for costs from their own pocket.

We rate his claim Mostly True.

U.S. Sen. Ron Johnson, R-Wis., has been adamant that spending on health care must come down.